Long-Term Results of Surgical Treatment Gastroesophageal Reflux Disease in Combination Hiatal Hernia

Abstract

Aim to study the long-term results of surgical treatment of gastroesophageal reflux disease (GERD) in combination with hiatal hernia to optimize the selection of patients for surgical treatment. Materials and Methods. The study included 41 patients aged 24 to 71 years (mean age 49.9±4.95 years), operated for gastroesophageal reflux disease in combination with hiatal hernia Patients underwent the following surgery: laparoscopic fundoplication according to Toupet, laparoscopic fundoplication according to Nissen, partial fundoplication according to Chernousov. The following interventions were performed simultaneously with laparoscopic fundoplication in a number of patients: cruroraphy in 36 patients, cholecystectomy for gallstone disease in 10 patients and selective proximal vagotomy in 6 patients. Results. It is revealed that in the postoperative period subjective manifestations of GERD not always correspond to endoscopic degree of GERD. A body mass index is a reliable predictor of postoperative recurrence of GERD and hiatal hernia, that it is necessary to consider at selection of patients for surgical treatment. Conclusions. Operation of a laparoscopic Toupet fundoplication with a bilateral krurorafiya is associated with the best postoperative results. The selective proximal vagotomy in addition to anti-reflux operation authentically improves clinical result.