Five years of experience in surgical treatment of hiatal hernias of types II–IV

INTROUCTION. Hiatal hernias of types II–IV are a common pathology, in which the abdominal organs are displaced into the mediastinum through the hiatus esophagus parallel to the esophagus, which is an absolute indication for surgical treatment. The article presents five years of experience in surgical treatment of hiatal hernias of types II–IV at a multidisciplinary regional hospital.

THE OBJECTIVE WAS to analyze the long-term results of treatment of hiatal hernias of types II–IV.

METHODS AND MATERIALS. In the period from 2013 to 2017, 150 patients with hiatal hernias of types II–IV were operated on in the Department of Thoracic Surgery of the Murmansk Regional Clinical Hospital named after P.A. Bayandin. All patients underwent laparoscopic surgeries: elimination of hiatal hernia, cruroraphy, fundoplication. An assessment of the remote results of treatment, in periods of two to five years, was carried out in 116 (77.3 %) patients using clinical and instrumental examination: radiography of the esophagus, stomach with a contrast agent (BaSO4) and esophagogastroduodenoscopy.

RESULTS. A good long-term result was recorded in 79 (68.1 %) of 116 patients, satisfactory – in 6 (5.2 %), and unsatisfactory – in 31 (26.7 %) patients.

CONCLUSION. Retrospective analysis of the results of treatment of hiatal hernias of types II–IV makes us consider this problem to be far from being solved. The use of prostheses to correct the size of the hiatal opening does not always allow us to avoid relapse of the disease. To improve the remote results of treatment of this pathology, it is necessary to search for new tactical and technical approaches.

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