Fundoplication in modification of the Russian scientific center of surgery in the treatment of patients with gastroesophageal reflux disease

• Yurasov A.V.
• T.T. Bitarov
• D.V. Pastukhov
• I.M. Selivanova
• A.L. Shestakov

Abstract

Aim. The aim is to assess the capability of safe fundoplication in modifications by laparotomic method and to evaluate the effectiveness of this method in comparison with classic laparotomic method.

Methods. The surgical treatment experiment of 145 patients of the 30 to 72 age bracket with reflux esophagitis (gastroesophageal reflux disease) was carried out in Petrovsky scientific surgery centre. The fundoplication in modifications was performed by laparotomic method at these 100 patients. Surgery of 45 patients in main group was performed by laparoscopic method. Indications for fundoplication were: severe reflux esophagitis, beyond the conservative therapy, complicated by Barrett's esophagus and peptic strictures of the distal esophagus, gastroesophageal reflux disease against the background of a hernia hiatal, the results of daily pH-metry.

The fundoplication efficiency was based on the results of patients’ examinations (esophagogastroduodenoscopy, fluoroscopy, daily pH-monitoring) with taking into consideration personal sensations of each patient.

Main results. The advantages of laparoscopic fundoplication over laparotomic operation were analyzed according to the results of the experiment. The results of the research show the advantages of laparoscopic fundoplication over laparotomic. Both groups had good results after surgical treatment (95 and 94%). 2% patients of the main group and 6% of the control group showed saticfactory results. Two patients of the main group were diagnosed mild reflux esophagit and they had to keep to a diet and take antiacid periodically. 5% of the contol group were diagnosed mild dysphagiad, 2% of patients had reflux esophagitis recurrent during 5 year supervision.

Conclusion. The effectiveness of laparoscopic fundoplication in modifications during cardiac hernia hiatal and reflux esophagitis is highly competitive with open operation. 43 (95%) patients show great result.

Keywords:laparoscopic fundoplication, gastroesophageal reflux disease, daily pH-metry

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