RESULTS OF ENDOVIDIOSURGERY INTERVENTIONS WITH BENIGN DISEASES OF THE ESOPHAGUS

Background. The most common benign diseases of the esophagus are achalasia cardia and hiatal hernia. Benign tumors of the esophagus are rare. The choice of surgical approach and a number of technical points when performing operations on the esophagus is important today.

The aim is studying results of surgical treatment of patients with benign diseases of the esophagus.

Methods. Laparoscopic myotomy and fundoplication was performed in 148 patients; laparoscopic fundoplication and crural closure — 89 patients, various types of refundoplication — 9 patients, laparoscopic enucleation of leiomyoma of the esophagus or stomach — 7 patients, thoracoscopic resection of esophageal diverticulum — 1 patient.

Results. Term follow-up was 1–13 years. Excellent and good results after laparoscopic myotomy were obtained in 144 (97.3 %) patients, intraoperative complications were observed in 8 patients, relapsed achalasia — 3 patients, developed reflux esophagitis — 1 patient. Excellent and good results after laparoscopic fundoplication were obtained in 84 (94.4 %) patients. Intraoperative complications were observed in 10 (7 %) patients. Poor treatment results were obtained in 4 patients; 3 (3.4 %) patients had relapsed hiatal hernia. Intensified expression of Barrett’s esophagus was observed in 2 (2.2 %) patients after 1 and 2 years after antireflux surgery; 2 patients were performed Nissen refundoplication, 1 of them also was made stem vagotomy; 3 patients performed laparoscopic refundoplication; 4 patients with partial fundoplication were performed complete fundoplication.

Conclusions. Laparoscopic method allows to get excellent and good results in 93–96 % of patients in the remote period. Laparoscopic fundoplication and myotomy is the operation of choice in the surgical treatment of achalasia cardia and hiatal hernia.