Main Article Content
The physiological incompetent cardia is a condition that is accompanied by reflux of gastric contents into the esophagus — gastroesophageal reflux disease, migration of a part of the stomach into the chest cavity — hiatal hernia. The main task of the surgical treatment of hiatal hernia is the correction of anatomical and physiological disorders: elimination of a hernia, correction of the antireflux function of the lower esophageal sphincter, and provision of the free antegrade passage of food. There is a large number of operations (more than 60 proposed methods) that are used in the surgical treatment of hiatal hernias, as well as gastroesophageal reflux disease. The article presents a method of surgical correction of the physiological incompetent cardia, ensures reliable restoration of the physiological cardia and preservation of the anatomical relationship of the diaphragm and the zone of the esophageal-gastric junction. It includes cruraphy and fundoplication. Cruraphy is performed with U-shaped sutures, which are placed on the right and left walls of the esophagus at the level of the cardia, with the crura of diaphragm fixed in them, corrugated sutures, which are applied to the medial pedicle of the diaphragm, reduce the esophageal opening of the diaphragm to the outer diameter of the esophagus and perpendicular to the axis of the esophagus as U-shaped sutures perform cardiogastric plication of the anterior wall of the stomach, followed by gastro-diaphragmopexy. The proposed method was used to treat 11 patients, the postoperative condition of the patients was satisfactory, without signs of postoperative dysphagic disorders. In all cases, good immediate and long-term results were obtained for a period of 6 months to 1 year. The use of the proposed method allows avoiding postoperative dysphagia and recurrence of the disease.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Our edition uses the copyright terms of Creative Commons for open access journals.
Authors, who are published in this journal, agree with the following terms:
- The authors retain rights for authorship of their article and grant to the edition the right of first publication of the article on a Creative Commons Attribution 4.0 International License, which allows others to freely distribute the published article, with the obligatory reference to the authors of original works and original publication in this journal.
- Directing the article for the publication to the editorial board (publisher), the author agrees with transmitting of rights for the protection and using the article, including parts of the article, which are protected by the copyrights, such as the author’s photo, pictures, charts, tables, etc., including the reproduction in the media and the Internet; for distributing; for the translation of the manuscript in all languages; for export and import of the publications copies of the writers’ article to spread, bringing to the general information.
- The rights mentioned above authors transfer to the edition (publisher) for the unlimited period of validity and on the territory of all countries of the world.
- The authors guarantee that they have exclusive rights for using of the article, which they have sent to the edition (publisher). The edition (the publisher) is not responsible for the violation of given guarantees by the authors to the third parties.
- The authors have the right to conclude separate supplement agreements that relate to non-exclusive distribution of their article in the form in which it had been published in the journal (for example, to upload the work to the online storage of the journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this journal is included.
- The policy of the journal permits and encourages the publication of the article in the Internet (in institutional repository or on a personal website) by the authors, because it contributes to productive scientific discussion and a positive effect on efficiency and dynamics of the citation of the article.
- The rights to the article are deemed transferred by the authors to the edition (the publisher) since the moment of the publication of the article in the printed or electronic version of journal.
Kalinina EA, Pryakhin AN. Technical aspects of laparoscopic plastic hernia repair: literture review and own experience. Bulletin of the South Ural State University. Education, health care, physical culture. 2014;14(3):54-60. (in Russian).
Mikhin IV, Kukhtenko IuV. Gryzhi pishchevodnogo otverstiia diafragmy: uchebnoe posobie [Hiatus hernia: a study guide]. Volgograd: VolgGMU; 2014. 72 p. (in Russian).
Velygotsky MM, Gorbulich OV, Komarchuk VV. Prevention of adverse outcomes of laparoscopic correction of antireflux function in patients with reflux disease and achalasia. Odessa Medical Journal. 2016;(149):66-69. (in Ukrainian).
Volchkova IS. Volchkova IS. Laparoskopicheskaia korrektsiia anatomo-funktsional'nykh narushenii pri khirurgicheskikh zabolevaniiakh ezofagokardial'noi zony. Diss. dokt. med. nauk [Laparoscopic correction of anatomical and functional disorders in surgical diseases of the esophagocardial zone. Dr. med. sci. diss.]. Astana; 2012. 282 p. (in Russian).
Baziev AM, Baksanocov ZN, Glashev TJ, Kalibatov RM, Teuvov AA. Experience with video-endoscopic technologies in the treatment of hernias hiatal and gastroesophageal reflux disease in terms of general hospital. Journal of New Medical Technologies. 2018;(2):68-73. doi:10.24411/2075-4094-2018-16015. (in Russian).
Zhurbenko GA, Karpitsky AS. Laparoscopic valve fundoplication as a method of surgical treatment of diaphragm esophageal hernia. Novosti Khirurgii. 2015;23(1):23-29. doi:10.18484/2305-0047.2015.1.23. (in Russian).
Ospanov OB, Volchkov IS. Results of endoscopic estimation of the esophagrogastic transition in gastroesophageal reflux illness before and after anti-reflux surgery. Medicine and Education in Siberia. 2011;(6):23. (in Russian).
Broeders JA, Mauritz FA, Ahmed Ali U, et al. Systematic review and meta-analysis of laparoscopic Nissen (posterior total) versus Toupet (posterior partial) fundoplication for gastro-oesophageal reflux disease. Br J Surg. 2010 Sep;97(9):1318-1330. doi:10.1002/bjs.7174.
Dmytryenko OP. Laparoskopichna fundoplykacija v hirurgichnomu likuvanni hvoryh na gastroэzofageal'nu refljuksnu hvorobu. Diss. kand. med. nauk [Laparoscopic fundoplication in the surgical treatment of patients with gastroesophageal reflux disease. PhD in Med Sci diss.]. Kyiv; 2016. 20 p. (in Ukrainian).
Hoshino M, Omura N, Yano F, et al. Backflow prevention mechanism of laparoscopic Toupet fundoplication using high-resolution manometry. Surg Endosc. 2016 Jul;30(7):2703-2710. doi:10.1007/s00464-015-4532-z.
Morales-Conde S, Lopez Bernal F, Alarcón I. Minimally Invasive Surgery of Paraesophageal Hernias. In: Asunción Acosta M, Cuesta MA, Bruna M, editors. Atlas of Minimally Invasive Techniques in Upper Gastrointestinal Surgery. Cham: Springer; 2021. doi:10.1007/978-3-030-55176-6_6. 39-45 pp.
Rawlings A, Soper NJ, Oelschlager B, et al. Laparoscopic Dor versus Toupet fundoplication following Heller myotomy for achalasia: results of a multicenter, prospective, randomized-controlled trial. Surg Endosc. 2012 Jan;26(1):18-26. doi:10.1007/s00464-011-1822-y.
Devyatkin AY, Chugunov AN, Gouriev EN. Application of ultrasonic studies dimensional volume image reconstruction in the diagnosis of a hiatal hernia. Practical medicine. 2012;(65):146-150. (in Russian).
Oskretkov VI, Gankov VA, Klimov AG, Gur’ianov AA, Fedorov VV, Kazarian VM, authors; Oskretkov VI, editor. Videoendoskopicheskaia khirurgiia pishchevoda [Video endoscopic surgery of the esophagus]. Barnaul: Az Buka; 2004. 159 p. (in Russian).
Puchkov KV, Filimonov VB, Ivanova TB. Comparative assessment of the immediate and long-term results of surgical treatment of patients with gastroesophageal reflux disease and some aspects of the choice of the fundoplication method. Endoskopicheskaya khirurgiya. 2002;8(6):31-39. (in Russian).
Matviychuk BO, Hurayevskyy AA, Stasyshyn AR. Experience of performance of laparoscopic operations in patients, suffering hiatal hernias and gastroesophageal reflux disease. Klinichna khirurhiia. 2018;85(12):23-25. doi:10.26779/2522-1396.2018.12.23. (in Ukrainian).
Sovpel IV, Ishchenko RV, Grintsov AG, Mikhaylichenko VYu, Sovpel OV. Ways of correction of esophagus shortening in gastroesophageal hernia surgery. Meditsinskii vestnik MVD. 2021;(110):42-50. (in Russian).
Grubnik VV, Malinovsky AV. Comparison of laparoscopic crurography and plasty, using lightweight net transplant in large hiatal hernias: remote results of prospective randomized investigation. Klinichna khirurhiia. 2016;(9):14-18. (in Russian).