Complications After Antireflux Surgery (ARS) and Managements

The primary goal of antireflux surgery is to anatomically restore the antireflux barrier and thereby reduce gastroesophageal reflux episodes. The application of laparoscopy to antireflux surgery has decreased patient morbidity and hospital length of stay and has replaced the open abdominal Nissen fundoplication as the procedure of choice. Laparoscopic antireflux surgery (LARS) is a safe operation when it is performed by experienced surgeons. Perioperative mortality rates range from 0.1 to 0.2%, and prolonged structural complications occur in up to 30% of cases. Complications that are specific to antireflux surgery include infection, bleeding, and esophagogastric perforation. In addition, LARS can result in postoperative functional complications, including dysphagia, gas-bloat syndrome, and diarrhea. Reoperation is best reserved for severe structural abnormalities and troublesome symptoms those that are not responsible for medical and endoscopic therapy.