Treatment of reflux esophagitis in patients with cardiofundal, subtotal and total hiatal hernias
AIM: To analyze treatment of patients with reflux esophagitis and large hiatal hernia.
MATERIAL AND METHODS: There were 85 patients with reflux esophagitis and large hiatal hernia. Laparoscopic repair was performed in 33 patients, laparotomy - in 52 cases. All patients underwent fundo- or gastroplication by A.F. Chernousov, correction of large defect of hiatal orifice by cruroraphy was applied in 55 (64.7%) patients.
RESULTS: Postoperative morbidity was near 10% after laparoscopic and conventional surgery despite more difficult video-assisted endoscopic technique. Complications Clavien-Dindo grade I-II were noted in 4 (12.1%) patients after laparoscopic treatment and in 6 (11.5%) patients after laparotomy. Medication was effective in all cases. Two patients with subtotal hernias had complications Clavien-Dindo grade IIIB after endoscopic surgery: recurrent hiatal hernia followed by severe reflux esophagitis and dysphagia. These complications required redo surgery. Repair of hiatal orifice is always possible without mesh reinforcement. Posterior cruroraphy is feasible and effective in all patients. Incidence of intraoperative and postoperative complications is comparable in both approaches (p<0.05). Mean hospital-stay after laparotomy was 7.3 days, after laparoscopy - 5.8 days.
CONCLUSION: Endoscopic formation of antireflux cuff by A.F. Chernousov is appropriate and effective in patients with reflux esophagitis and large/giant hiatal hernias.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2019 |
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| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2019 |
|---|---|
| Enthalten in: |
Khirurgiia - (2019), 6 vom: 18., Seite 41-48 |
| Sprache: |
Russisch |
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| Weiterer Titel: |
Lechenie refliuks-ézofagita u bol'nykh s kardiofundal'nymi, subtotal'nymi i total'nymi gryzhami pishchevogo otverstiia diafragmy |
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| Beteiligte Personen: |
Chernousov, A F [VerfasserIn] |
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| Links: |
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| Themen: |
Cruroraphy |
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| Anmerkungen: |
Date Completed 03.09.2019 Date Revised 03.09.2019 published: Print Citation Status MEDLINE |
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| doi: |
10.17116/hirurgia201906141 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM299304841 |
|---|
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| 245 | 1 | 0 | |a Treatment of reflux esophagitis in patients with cardiofundal, subtotal and total hiatal hernias |
| 246 | 3 | 3 | |a Lechenie refliuks-ézofagita u bol'nykh s kardiofundal'nymi, subtotal'nymi i total'nymi gryzhami pishchevogo otverstiia diafragmy |
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| 500 | |a Date Completed 03.09.2019 | ||
| 500 | |a Date Revised 03.09.2019 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a AIM: To analyze treatment of patients with reflux esophagitis and large hiatal hernia | ||
| 520 | |a MATERIAL AND METHODS: There were 85 patients with reflux esophagitis and large hiatal hernia. Laparoscopic repair was performed in 33 patients, laparotomy - in 52 cases. All patients underwent fundo- or gastroplication by A.F. Chernousov, correction of large defect of hiatal orifice by cruroraphy was applied in 55 (64.7%) patients | ||
| 520 | |a RESULTS: Postoperative morbidity was near 10% after laparoscopic and conventional surgery despite more difficult video-assisted endoscopic technique. Complications Clavien-Dindo grade I-II were noted in 4 (12.1%) patients after laparoscopic treatment and in 6 (11.5%) patients after laparotomy. Medication was effective in all cases. Two patients with subtotal hernias had complications Clavien-Dindo grade IIIB after endoscopic surgery: recurrent hiatal hernia followed by severe reflux esophagitis and dysphagia. These complications required redo surgery. Repair of hiatal orifice is always possible without mesh reinforcement. Posterior cruroraphy is feasible and effective in all patients. Incidence of intraoperative and postoperative complications is comparable in both approaches (p<0.05). Mean hospital-stay after laparotomy was 7.3 days, after laparoscopy - 5.8 days | ||
| 520 | |a CONCLUSION: Endoscopic formation of antireflux cuff by A.F. Chernousov is appropriate and effective in patients with reflux esophagitis and large/giant hiatal hernias | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a GERD | |
| 650 | 4 | |a cruroraphy | |
| 650 | 4 | |a fundoplication | |
| 650 | 4 | |a large hiatal hernia | |
| 650 | 4 | |a reflux esophagitis | |
| 650 | 4 | |a surgical treatment of HH | |
| 650 | 4 | |a treatment of GERD | |
| 650 | 4 | |a treatment of reflux esophagitis | |
| 700 | 1 | |a Khorobrykh, T V |e verfasserin |4 aut | |
| 700 | 1 | |a Vetshev, F P |e verfasserin |4 aut | |
| 700 | 1 | |a Osminin, S V |e verfasserin |4 aut | |
| 700 | 1 | |a Korotkiy, V I |e verfasserin |4 aut | |
| 700 | 1 | |a Abdulkhakkimov, N M |e verfasserin |4 aut | |
| 700 | 1 | |a Chesarev, A A |e verfasserin |4 aut | |
| 700 | 1 | |a Salikhov, R |e verfasserin |4 aut | |
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