Dysphagia after antireflux surgery

Br J Surg. 2001 Apr;88(4):486-99. doi: 10.1046/j.1365-2168.2001.01662.x.


Background: Dysphagia is experienced by many patients after antireflux surgery. This literature review examines factors associated with the development, prediction and management of postoperative dysphagia.

Methods: Published studies examining issues related to dysphagia, gastro-oesophageal reflux and fundoplication were reviewed.

Results: Postoperative dysphagia is usually temporary but proves troublesome for 5--10 per cent of patients. Technical modifications, such as a partial wrap, division of short gastric vessels and method of hiatal closure, have not conclusively reduced its incidence. There is no reliable preoperative test to predict dysphagia.

Conclusion: It is uncertain whether postoperative dysphagia arises from patient predilection or is largely a consequence of mechanical changes created by fundoplication. Anatomical errors account for a significant proportion of patients referred for correction of dysphagia but these are uncommon in large single-institution studies. Abnormal manometry cannot predict dysphagia and, on current evidence, 'tailoring' the operation does not prevent its occurrence.

Publication types

  • Review

MeSH terms

  • Deglutition Disorders / etiology*
  • Fundoplication / adverse effects
  • Gastroesophageal Reflux / surgery*
  • Humans
  • Laparoscopy
  • Manometry / methods
  • Postoperative Complications / etiology*