Diagnosis and treatment of gas-bloat syndrome after antireflux surgery

Abstract

The aim of the study was to assess the frequency of complications after laparoscopic Nissen fundoplication in patients with a hernia of the esophageal orifice of the diaphragm, to determine the features of diagnosis and treatment of gas-bloat syndrome. Materials and methods. According to the results of the meta-analysis, 10 % of patients with esophageal hiatal hernia developed inability to belch, 19 % – gas-bloat syndrome, 59 % – flatulence after laparoscopic Nissen fundoplication. The treatment results of two patients with gas-bloat syndrome at the SI “Shalimov’s National Institute of Surgery and Transplantation” of the National Academy of Medical Sciences of Ukraine for the period 2018–2020 are presented. Reconstructive fundoplication according to Toupet was performed in one patient, and one patient underwent endoscopic dilatation of the esophagogastric junction using a Boston Scientific 3.0 balloon. Conclusions. Pain reduction after a nasogastric tube placement and air venting from it is a tool to diagnose gas-bloat syndrome. Increasing aerogastria and stomach enlargement in 30–60 minutes after an additional meal make X-ray examination more informative and can be considered as new radiological symptoms. Toupet refundoplication is an effective surgical treatment for gas-bloat syndrome in patients after complete Nissen fundoplication.