Novosti
Khirurgii

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Year 2014 Vol. 22 No 2

GENERAL AND SPECIAL SURGERY

O.A. BAULINA, A.S. IVACHEV, V.A. BAULIN, À.À. BAULIN

LAPAROSCOPIC FIXATION OF HIS ANGLE USING XENOPERICARDIAL BAND IN PATIENTS WITH GASTROESOPHAGEAL REFLUX DISEASE

SBEE APE “Penza Institute of Physicians’ Advanced Training”,
The Russian Federation

Objectives. To carry out a comparative evaluation of the results of laparoscopic His angle fixation with the polypropylene mesh and xenopericardial band in patients with gastroesophageal reflux disease.
Methods. Depending on the fixation material type used for the laparoscopic His angle fixation the patients were divided into two groups. In the main group (32 patients) antireflux surgery was performed using biological implant – the calf pericardium. In the comparison group (162 patients) – surgery was performed using polypropylene mesh as a fixation material.
Results. Indications for antireflux surgery were: reflux esophagitis, extraesophageal manifestations of gastroesophageal reflux disease, failure of the cardia, hiatal hernia, ineffective conservative treatment, expressed clinic of gastroesophageal reflux disease, reduction quality of life, the impossibility of an adequate medical treatment due to economic factors, combined abdominal pathology, patient preference even with an effective treatment in the case of the reduced quality of life, lifelong need for conservative treatment and its high cost. In both groups, attention was paid primarily to the prosthesis-associated complications. In the main group there were no such complications and early postoperative complications were: dysphagia during 3 days (3,1%); hyperthermia during 2 days (34,4%). In the distant postoperative period, 95% of clinic, endoscopic and radiographic results may be regarded as good and excellent. In the comparison group prosthesis-related the following complications were observed: suppuration in the mesh area (1,9%); mesh eruption through the posterior wall into the lumen of the esophagus (5,6%); foreign body sensation (2,5%). In the distant period good and excellent results make up 89,5%.
Conclusions. The first positive short- and long-term results manifested good prospects of the new method, using the xenopericardial plate as a fixation material, and possibilities of its introduction in the antireflux surgery.

Keywords: gastroesophageal reflux disease, surgical treatment, laparoscopic fixation of His angle, xenopericard, polypropylene mesh
p. 164 – 170 of the original issue
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Address for correspondence:
440060, Rossiiskaia Federatsiia, g. Penza, ul. Stasova, d. 8 A, GBOU DPO «Penzenskii institut usovershenstvovaniia vrachei», kafedra khirurgii i endoskopii,
e-mail: olga.kosenko@mail.ru,
Baulina Ol'ga Aleksandrovna
Information about the authors:
Baulina O.A. A post-graduate student of the surgery and endoscopy chair of SBEE APE “Penza Institute for Advanced Training of Physicians”.
Ivachev A.S. MD, professor, a head of the surgery and endoscopy chair of SBEE APE “Penza Institute for Advanced Training of Physicians”.
Baulin V.A. PhD, an assistant of the surgery and endoscopy chair of SBEE APE “Penza Institute for Advanced Training of Physicians”.
Baulin A.A. MD, professor of the surgery and endoscopy chair of SBEE APE “Penza Institute for Advanced Training of Physicians”.
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