Managment of Dysphagia after Laparoscopic Antireflux Surgeries

Background: The complex gastro-oesophageal reflux disorder (GERD) that affects adults is linked to histologic or macroscopic oesophageal abnormalities. After the age of 40, the prevalence of GERD rises, and it is not unusual for symptomatic people to put off seeking medical attention for years. Aim: To evaluate the incidence, aetiology, diagnosis and management strategies for dysphagia after laparoscopic antireflux surgeries. Subjects and methods: The 40 patients who underwent laparoscopic fundoplication at Al-Hussain and Sayed Galal-Bab El-sheria, the Department of General Surgery at Al-Azhar University Hospitals, for gastro-oesophageal reflux disease and/or hiatal hernia between July 10, 2024, and April 10, 2025, were the subjects of this prospective study. Results: There was a statistically significant difference in the incidence of dysphagia between the groups examined immediately after surgery (P=0.004), with group C showing the lowest proportion and group A the highest. There was no statistically significant difference in the incidence of dysphagia among the groups that were evaluated after 6 months. In terms of management, out of the total number of patients treated, 22 (70.97%) in group A, 2 (40%) in group B, and 4 (100%) in the control group experienced a marked improvement after 12 weeks of medication. Six (19.35%) patients in group A, two (40%) in group B, and none in group C underwent endoscopic dilatation, and three (9.68%) patients in group A, one (20%) in group B, and none in group C required a second round of surgery. When looking at outcomes and management, the groups that were evaluated showed no significant difference. Conclusion: All three techniques are comparable in terms of postoperative outcomes, radiological findings, operative time and upper endoscopy findings, except for the incidence of dysphagia, as Nissen fundoplication has the highest incidence and Dor fundoplication has the lowest one. But after 6 months, all of them showed a similar incidence of dysphagia. Management varies from conservative TTT to endoscopic dilatation and surgical reintervention.