HIATAL HERNIA: ANALYSIS OF DIAGNOSIS AND TREATMENT
DOI:
https://doi.org/10.11603/2414-4533.2024.2.14853Keywords:
hiatal hernia, complications, diagnosis, treatmentAbstract
The aim of the work: to analyze retrospectively the results of treatment of patients with hiatal hernia and gastroesophageal reflux disease (GERD).
Materials and Methods. The results of treatment of 322 patients with hiatal hernia and GERD, which were treated at the Department of Surgery, Plastic Surgery and Endoscopy of Danylo Halytsky Lviv National Medical University at the Department of Surgery and Oncology of the 1st TMU of Lviv from 2021 to 2023, were analyzed. There were 182 women and 140 men, the average age of the patients was (54.7±3.2) years, and the average body mass index was 33.5 kg/m2. We analyzed patients' complaints and anamnesis, duration of symptoms, preoperative instrumental studies, various methods and techniques of surgery, surgery time, length of hospital stay, intra- and early postoperative complications.
Results. Laparoscopic Nissen fundoplication was performed in 131 patients (71.6 %). Laparoscopic Nissen-Rossetti fundoplication was performed in 37 patients (20.2 %); Toupet fundoplication was performed in 3 patients (1.6 %), Dor fundoplication - in 1 patient (0.5 %), and robotic Nissen fundoplication - in 6 patients (3.3 %). Open surgery was performed in 5 cases (2.7 %). Complications associated with hiatal hernia and GERD were diagnosed in 73 patients (24.1%): anemia – 21 cases (6.9 %), Cameron's ulcer with bleeding – 27 cases (8.9 %), esophageal stricture – 16 cases (5.3 %); CLE and Barrett's esophagus – 8 cases (2.6 %), and esophageal cancer – 1 case (0.3 %). Intraoperative complications included spleen injury with bleeding in 1 patient (0.5 %), esophageal perforation in 1 patient (0.5 %), pneumothorax in 9 patients (4.9 %). Narrowing of the esophageal opening of the diaphragm at the level of the fundoplication cuff in the postoperative period - in 11 patients (6.01%); repeated laparoscopy – 1 case (0.5 %). 3 patients (1.6 %) were re-hospitalized 1 month after surgery with recurrence of hiatal hernia and GERD.
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