Saratov JOURNAL of Medical and Scientific Research

hiatal hernia

Causes of failures and indications for refundoplication of antireflux surgery

Year: 2016, volume 12 Issue: №3 Pages: 408-411
Heading: Surgery Article type: Original article
Authors: Khubolov A.M.
Organization: Saratov State Medical University
Summary:

The aim is to study reasons for repeated fundoplication and possible variants of cardia correction in patients suffering from hiatal hernia and reflux esophagitis. Material and methods. Results of antireflux correction in 118 patients suffering from hiatal hernia have been studied, such results have been observed for the period of up to 36 months. Results. Most recurrent cases have been characterized by anatomical background for repeat hernia development, such as migration of fundoplication cuff, inconsistency, extreme traction of tissues that form gastric cuff or derived technique of fundoplication during previous operation. It has been found out that the subjective assessment of patients' condition after fundoplication is one of the most important criteria in deciding whether the repeated intervention is needed. Conclusion. Analysis of long-term results of the repeated antireflux surgery has revealed that quality-of-life index of patients having undergone repeated surgery may be compared to that of a healthy person. Traditional fundoplication of Nissen with non-tractional surgical intervention should be the method of choice for treatment of recurrent hiatal hernias.

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Results of repeated antireflux operations on hiatal hernias

Year: 2016, volume 12 Issue: №2 Pages: 191-195
Heading: Surgery Article type: Original article
Authors: Khubolov A.M.
Organization: Saratov State Medical University
Summary:

The research goal: to carry out the retrospective analysis of results of repeated antireflux interventions at the recurrent hernias of an esophageal opening of a diaphragm (HEOD). Material and methods. Results of surgical treatment of 38 patients with recurrence of HEOD in various terms after operation are studied. Results. At the most part of patients at repeated operations anatomic prerequisites to formation of recurrence of HEOD — migration of a fundoplication cuff, insolvency, an excessive tension of tissues when forming the gastric coupling, violation of technology of imposing of a cuff come to light. In this regard, proceeding from these references and the analysis of own research, it has been considered that plasticity of local tissues at recurrent HEOD, is insufficient for reliable elimination of a gastroesopha-geal reflux. Conclusion. The analysis of the results of antireflux surgical treatment of HEOD with a reflux-esophageal phenomenon has shown high efficiency of no tension plasticity, with use of a synthetic artificial limb. The fundoplication technique in antireflux surgery with no tension plasticity may be used as an operation of choice at recurrent hernias of an esophageal opening of a diaphragm.

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Experience of antireflux surgery application for the treatment of gastroesophageal reflux disease

Year: 2015, volume 11 Issue: №4 Pages: 583-586
Heading: Surgery Article type: Original article
Authors: Tolstokorov A.S., Khubolov A.M., Kovalenko Yu.V.
Organization: Saratov State Medical University
Summary:

Purpose of the study: post-hoc analysis of mid-term and late results of various types of antireflux surgery performed to treat hiatal hernia. Material and methods. We have studied results of post-surgery examination of 118 patients diagnosed with hiatal hernia, the examination being performed at various time intervals after surgeries. Results. The only benefits of using laparoscopic treatment include cosmetic effect, shorter terms of hospital stay and recovery of person's capacity to work. Conclusion. Analysis of immediate and late results of surgical treatment of gastroesophageal reflux disease as well as frequency of postsurgical relapses provided no certain evidence of significant beneficial effect for choosing laparoscopic surgical methods over traditional open surgery.

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