{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:26:31Z","timestamp":1760059591175,"version":"build-2065373602"},"reference-count":50,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T00:00:00Z","timestamp":1750982400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Laparoscopic antireflux surgery (LARS) is widely used to treat gastroesophageal reflux disease (GERD). Iatrogenic gastroesophageal injuries, when recognized intraoperatively, can be managed without major consequences, whereas undetected injuries presenting as postoperative leaks are associated with high morbidity and mortality. Despite their complexity, research on post-LARS leaks is scant. We aim to describe the diagnosis and management of such injuries at a tertiary referral center. Methods: We describe a single-center case series of patients referred for gastroesophageal perforations after LARS. Patients were identified through the personal records of surgeons at our institution. A narrative literature review was conducted to summarize publications on the topic. Results: Five patients (four female [80%]; median age, 73 years [IQR, 67\u201374]) were included. The median time between LARS and clinical presentation was 2 (IQR, 1\u20138) days (range 1\u201315 days). The most frequent symptoms were shortness of breath (all five patients) and pain (three [60%] patients). All patients presented with hypoxia, and four (80%) patients presented with sepsis. Two (40%) patients underwent primary repair, and three (60%) required limited esophagogastrectomy without immediate reconstruction. All patients required both thoracic and abdominal exploration, and all of them experienced significant postoperative complications (Clavien\u2013Dindo \u2265 3). The median hospital stay was 58 days (IQR, 34\u201359). At a median follow-up of 14 months (IQR, 6\u201328), all patients were alive. Conclusions: Although infrequent, gastroesophageal perforation after LARS often requires complex surgical interventions and prolonged hospital stays. Additional efforts should focus on prevention and early recognition.<\/jats:p>","DOI":"10.3390\/jcm14134577","type":"journal-article","created":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T13:06:17Z","timestamp":1751288777000},"page":"4577","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Missed Gastroesophageal Injuries During Antireflux Surgery: Infrequent but Catastrophic Complications"],"prefix":"10.3390","volume":"14","author":[{"given":"Arianna","family":"Vittori","sequence":"first","affiliation":[{"name":"Norton Thoracic Institute, St. Joseph\u2019s Hospital and Medical Center, Phoenix, AZ 85013, USA"},{"name":"Department of Surgery, Oncology and Gastroenterology, School of Medicine, University of Padua, 35128 Padova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3401-8623","authenticated-orcid":false,"given":"Andr\u00e9s R.","family":"Latorre-Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Norton Thoracic Institute, St. Joseph\u2019s Hospital and Medical Center, Phoenix, AZ 85013, USA"},{"name":"Grupo de Investigaci\u00f3n Cl\u00ednica, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogot\u00e1 D.C., Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7955-2454","authenticated-orcid":false,"given":"Andrew","family":"Keogan","sequence":"additional","affiliation":[{"name":"Norton Thoracic Institute, St. Joseph\u2019s Hospital and Medical Center, Phoenix, AZ 85013, USA"},{"name":"School of Medicine, Creighton University, Phoenix, AZ 85012, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jasmine","family":"Huang","sequence":"additional","affiliation":[{"name":"Norton Thoracic Institute, St. Joseph\u2019s Hospital and Medical Center, Phoenix, AZ 85013, USA"},{"name":"School of Medicine, Creighton University, Phoenix, AZ 85012, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lara","family":"Schaheen","sequence":"additional","affiliation":[{"name":"Norton Thoracic Institute, St. Joseph\u2019s Hospital and Medical Center, Phoenix, AZ 85013, USA"},{"name":"School of Medicine, Creighton University, Phoenix, AZ 85012, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ross M.","family":"Bremner","sequence":"additional","affiliation":[{"name":"Norton Thoracic Institute, St. Joseph\u2019s Hospital and Medical Center, Phoenix, AZ 85013, USA"},{"name":"School of Medicine, Creighton University, Phoenix, AZ 85012, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sumeet K.","family":"Mittal","sequence":"additional","affiliation":[{"name":"Norton Thoracic Institute, St. Joseph\u2019s Hospital and Medical Center, Phoenix, AZ 85013, USA"},{"name":"School of Medicine, Creighton University, Phoenix, AZ 85012, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1136\/gutjnl-2012-304269","article-title":"Update on the epidemiology of gastro-oesophageal reflux disease: A systematic review","volume":"63","author":"Sweet","year":"2014","journal-title":"Gut"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"4765","DOI":"10.1007\/s00464-024-11092-3","article-title":"SAGES guidelines for the surgical treatment of hiatal hernias","volume":"38","author":"Daly","year":"2024","journal-title":"Surg. 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