This journal is
indexed in Scopus
Year 2015 Vol. 23 No 1
GENERAL AND SPECIAL SURGERY
G.A. JURBENKO, A.S. KARPITSKI
LAPAROSCOPIC VALVE FUNDOPLICATION AS A METHOD OF SURGICAL TREATMENT OF HIATAL HERNIA
ME "Brest Regional Hospital",
The Republic of Belarus
Objectives. To improve surgical treatment outcomes of hiatal hernia by developing antireflux surgery includes a valve esophagofundoplication and an advanced method of Gis acute angle forming.
Methods. Efficiency assessment of 128 laparoscopic fundoplications has been conducted. Toupet fundoplication was applied in 54 (42,2%) patients (group 1); 61 (47,6%) patients underwent laparoscopic valve fundoplication according to their own technique (group 2) and 13 patients (10,2%) were operated by different operation methods application. The antireflux effect of the surgery in the patients (group 2) was achieved by creating a valve and Gis acute angle. The results of the surgery were evaluated in a survey using GERD-Q and GERD-HRQL questionnaires in the early and 1-1,5 years postoperative period.
Results. In the early postoperative period a comparable efficacy of both evaluated techniques was observed. 51 (94,5%) patients (group 1) and 56 (92%) patients (group 2) were satisfied with the surgery outcome.
The surgical treatment was evaluated in the late postoperative period in 26 (group 1) and 35 (group 2) patients. In the 1st group 5 out of 8 patients unsatisfied with the results the recurrence has occured, and 3 – suffered from gas-bloating symptom. 7 patients rated their overall health as neutral to abdominal pain, gas-bloating after meals and the necessity of regular conservative treatment. In the 2nd group there were two patients dissatisfied with the surgery outcomes due to the disease recurrence and gas-bloating syndrome. 8 patients rated their quality of life as neutral. Three of them suffered from recurrent heartburn, less often, though, than prior the surgery. Five patients suffered from moderate abdominal pain and bloating against the background of periodic administration of drugs improving the intestinal motility.
Conclusion. The Gis angle restoration is considered to be anatomically reasonable. It eliminates the risk of postoperative dysphagia and improves the quality of life in the late postoperative period.
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224027, Respublika Belarus,
g. Brest, ul. Meditsinskaya, d. 7,
UZ "Brestskaya oblastnaya bolnitsa",
otdelenie torakalnoy khirurgii,
tel. office: +375 016 27-21-80,
Jurbenko Gennadiy Anatolvich
Jurbenko G.A. A surgeon of the thoracic surgery unit of ME "Brest Regional Hospital".
Karpitski A.S. MD, professor, a Chief physician of ME "Brest Regional Hospital".