Actuality. Diagnosis and treatment of gastroesophageal reflex disease (GERD) — one of the most pressing problems of modern medicine. Progression and asymptomatic GERD can lead to serious complications such as stricture of the esophagus and Barrett’s esophagus. Barrett’s esophagus is registered in 5–15% of patients with endoscopy in patients with GERD symptoms. Laparoscopic antireflux surgery is an effective treatment for patients with GERD, but about 4% of patients in the remote period requiring reoperation. Repeated laparoscopic antireflux surgery feasible and safe but associated with a higher risk of complications and less effective than primary surgery.
The aim of the study. Studying results of surgical treatment of gastroesophageal reflex disease.
Materials and methods. There were operated laparoscopically in 65 patients with GERD. Men were 27 (41.5%), 38 women (58.5%), mean age was (48.7±7.8) years. Nonerosive reflux disease had 35 (53.8%) patients. In 7 patients there were diagnosed complications: Barrett’s esophagus — in 2 (3.1%) patients, esophageal ulcer — 2 (3.1%) patients, esophageal stricture — 3 (4.6%) patients. In 4 (6.2%) patients experienced night time reflux, 33 (50.8%) patients during the same day, in 28 (43.1%) patients in the daytime. Laparoscopic Nissen fundoplication performed 39 (60%) patients, according to Nissen–Rossetti — 4 (6.2%), by Toupet — 17 (26.2%) patients; by Nissen–Donahue — 5 (7.7%) patients. Crural closure was made in 60 (92.3%) patients, 2 (3.1%) — were implanted Proceed mesh prosthesis; conversion — 2 (3.1%) patients.
Results. Excellent and good results after laparoscopic fundoplication were obtained in 62 (95.4%) patients. At various times after surgery during the first 5 years, 3 (4.6%) patients relapsed GERD. After 2 years, 1 (1.5%) patient had manifestation of Barrett’s esophagus.
Conclusions. The use of laparoscopic fundoplication in the treatment of resistant forms or complicated course of gastroesophageal reflux disease is an effective treatment.