Surgical tactics in the treatment of patients with hiatal hernias

Main Article Content

N.V. Prolom
B.F. Shevchenko
A.M. Babii
S.A. Tarabarov
A.A. Galinsky

Abstract

Background. The purpose was to develop indications for surgical treatment of patients with hiatal hernias and evaluate its results. Materials and methods. At the Department of Surgery of Digestive Organs of SI “Institute of Gastroenterology of the National Academy of Medical Sciences of Ukraine”, 45 patients with hiatal hernias were examined in 2017–2019. Long-term treatment results were studied within 6 months to 2 years in 19 (42.2 %) individuals. Results. In our studies, among 45 operated patients, 27 (60.0 %) had a diagnosis of axial hiatal hernia (type I), 9 (20.0 %) — paraesophageal hiatal hernia (type II), 8 (17.8 %) — combined hiatal hernia (type III), 1 (2.2 %) patient had hiatal hernia with a shortening of the esophagus (type IV). Grade I of hiatal hernia was noted in 25 (55.6 %) people, grade II occurred in 12 (26.7 %), and grade III, when body and even the antral part of the stomach prolapse into the posterior mediastinum, — in 8 (17.8 %) patients. Cruroplasty was performed in 100 % of cases: posterior — in 24 (53.3 %) individuals, anterior and posterior (сombined) — in 13 (28.9 %), alloplasty — in 8 (17.8 %). Laparoscopic fundoplication was carried out in all patients: Nissen fundoplication — in 36 (80.0 %), Toupet fundoplication — in 6 (13.3 %), Dor fundoplication — in 3 (6.7 %). There were no fatal cases. The average duration of surgery was (135 ± 24) min, the average time of transplant fixation — (24 ± 12) min. Conclusions. Therefore, laparoscopic antireflux operations are highly effective in the treatment of hiatal hernias, well tolerated and characterized by a low percentage of complications (6 (13.3 %) cases), rapid recovery of patients in the postoperative period, allowing them to be recognized as surgery of choice in the treatment of this pathology. The choice of surgical procedure for hiatal hernia is determined by the features of anatomical interrelations and the purpose of restoring the esophageal-gastric junction and diaphragm.

Article Details

How to Cite
Prolom, N., Shevchenko, B., Babii, A., Tarabarov, S., & Galinsky, A. (2020). Surgical tactics in the treatment of patients with hiatal hernias. GASTROENTEROLOGY, 54(2), 107–112. https://doi.org/10.22141/2308-2097.54.2.2020.206229
Section
Original Researches

References

Velygotsky MM, Gorbulich OV, Komarchuk VV. Prevention of adverse outcomes of laparoscopic correction of antireflux function in patients with reflux disease and achalasia. Odes’kij medičnij žurnal. 2015;(149):66-69. (in Ukrainian).

Devyatkin AY, Chugunov AN, Guriev EN. Application of ultrasonic studies dimensional volume image reconstruction in the diagnosis of a hiatal hernia. Practical medicine. 2012;9(65):146-150. (in Russian).

Mikhin IV, Kukhtenko IuV. Gryzhi pishchevodnogo otverstiia diafragmy: uchebnoe posobie [Hernia of the esophageal orifice: a tutorial]. Volgograd: Volgograd State Medical University; 2014. 72p. (in Russian).

Jurbenko GA, Karpitski AS. Laparoscopic valve fundoplication as a method of surgical treatment of hiatal hernia. Novosti Khirurgii. 2015;23(1):23-29. doi:10.18484/2305-0047.2015.1.23. (in Russian).

Kalinina EA, Pryakhin AN. Technical aspects of laparascopic hiatal hernia repair: literture review and own experience. Human. Sport. Medicine. 2014;14(3):54-60. (in Russian).

Koetje JH, Nieuwenhuijs VB, Irvine T, Mayne GC, Watson DI. Measuring Outcomes of Laparoscopic Anti-reflux Surgery: Quality of Life Versus Symptom Scores? World J Surg. 2016;40(5):1137‐1144. doi:10.1007/s00268-015-3394-9.

Schietroma M, De Vita F, Carlei F, et al. Laparoscopic floppy Nissen fundoplication: 11-year follow-up. Surg Laparosc Endosc Percutan Tech. 2013;23(3):281‐285. doi:10.1097/SLE.0b013e31828e3954.

Lebenthal A, Waterford SD, Fisichella PM. Treatment and controversies in paraesophageal hernia repair. Front Surg. 2015;2:13. doi:10.3389/fsurg.2015.00013.

Koh YX, Ong LW, Lee J, Wong AS. Para-oesophageal and parahiatal hernias in an Asian acute care tertiary hospital: an underappreciated surgical condition. Singapore Med J. 2016;57(12):669‐675. doi:10.11622/smedj.2016018.

Lyons BE, Austin D, Seelye A, et al. Pervasive computing technologies to continuously assess Alzheimer's disease progression and intervention efficacy. Front Aging Neurosci. 2015;7:102. doi:10.3389/fnagi.2015.00102.

Most read articles by the same author(s)

1 2 > >>