Laparoscopic correction of recurrence of gastroesophageal reflux disease and hernia of the esophageal aperture of the diaphragm

Laparoscopic antireflux surgery are becoming more frequent tool in the treatment of gastroesophageal reflux disease (GERD). In this case, according to the literature, symptoms of dysphagia in the postoperative period arise again in 3-30% of patients, which leads to the fact that 3-6% of them are operated repeatedly. The aim of research: assessment mechanisms for recurrence of GERD and the ability to perform adequate surgical correction after primary antireflux surgery. Materials and methods: the team of authors during the period from 1993 to 2018 operated on 2,678 patients for GERD and hernia of the esophageal aperture of the diaphragm (GVAP). 127 (4.74%) patients underwent surgery for recurrent form of the disease, 46 from their initial operation is performed in other clinics. Results: the median follow-up of re-operated patients was 63 months (12 to 139 months). A satisfactory functional result was achieved in 76.4% of the reopened patients. Conclusion: during repeated surgery, it is necessary to separate the previously performed antireflux reconstruction, isolate both crura of the the diaphragm, and excise the hernial sac. In addition, it is necessary to know all the features of the course of the postoperative period in this category of patients, as well as the presence of a gastroenterologist in the team.