Re-operations for failed anti-reflux surgery. Lessons from the past and prospects for the future.

Objective: The total number of re-operations for failed antireflux surgery is increasing dramatically worldwide. We reviewed our experience of re-operations for failed anti-reflux surgery to identify the factors contributing to unsuccessful re-operation which can be used in the era of laparoscopic surgery.

Method: One hundred twenty one patients were re-operated.

Changing dogmas: history of development in treatment modalities of traumatic pneumothorax, hemothorax, and posttraumatic empyema thoracis.

Development of treatment modalities for chest wounds and traumatic empyema thoracis is reviewed in the light of war experience. Mortality from thoracic injury was more than 50% before World War I and was about 25% during World War I. It came down to 10% in World War II and was about 5% during the Korean War.

The influence of age on gastro-oesophageal reflux: a re-appraisal of the DeMeester scoring system.

Objective: The statistical evaluation of the influence of age on the pattern of gastro-oesophageal reflux (GOR) identified by prolonged pH monitoring in asymptomatic subjects. Re-appraisal of the DeMeester scoring system for GOR.

Method: Prolonged pH monitoring was performed on 45 asymptomatic elderly adults with normal contrast oesophagogram, manometry and endoscopy.