Abstract
Objective. To analyze the effectiveness of various methods of laparoscopic antireflux operations in patients with gastroesophageal reflux disease.
 Materials and methods. The results of treatment of 177 patients with gastroesophageal reflux disease from 2015 to 2021 were analyzed. Patients were divided into three groups: 1st - 62 patients who underwent laparoscopic antireflux surgery of our own modification (Patent of Ukraine No 59772); 2nd - 91 patients who underwent laparoscopic Nissen fundoplication; 3rd - 24 patients who underwent laparoscopic Toupet fundoplication. 
 Results. 36 months after surgery in the 1st group the recurrence rate of gastroesophageal disease was 1.6%, recurrence of hernia of the esophageal orifice - 1.6%, in the 2nd group - 7.7 and 3.3%, respectively; in the 3rd group - 12.5 and 8.3%, respectively.
 Conclusions. The application of a new integrated approach to the surgical treatment of gastroesophageal reflux disease reduces the number of postoperative complications (gas -bloat syndrome - 3 times, dysphagia - 5 times), the recurrence rate of gastroesophageal reflux disease - 5 times and recurrence of esophageal hernia - 2 times, improves the quality of life of patients 36 months after surgery in 2.6 times and increases the timeliness of diagnosis and facilitates the choice of differentiated treatment tactics.
Highlights
The distribution by grade of reflux esophagitis according to LA classification was as follows: 0 degree was observed in 60 patients (96.8%), grade A – in 2 (3.2%), grade B, C and D – in 0 (0%)
The relevance of the problem increases in case of complicated GERD and the development of extraesophageal manifestations of the disease, which complicates the diagnosis and selection of optimal treatment tactics
The recurrence rate after HH plastic averages 25%, reaching 60% and can be solved through a comprehensive approach to the diagnosis of GERD combined with HH
Summary
The therapeutic results among 177 patients with GERD, who were admitted during 2015-2021 to the clinic of surgery and endoscopy of the Faculty of postgraduate education of the Danylo Halytsky Lviv National Medical University, were analyzed. They were divided into 3 groups: Group I laparoscopic antireflux surgery using our own modification (patent of Ukraine No 59772), included 62 patients; Group II (91 patients) – laparoscopic Nissen fundoplication; Group III (24 patients) – laparoscopic Toupet fundoplication. The mean age of patients was 51.8 ± 12.1 (19-74) years. The mean body mass index (BMI) was 27.8 ± 4.5 (18.5-39.8) kg/m2. The distribution according to the grade of reflux esophagitis (LA classification) was as follows: grade A – 53 patients (29.9%), grade B – 82 patients (46.3%), grade C – 40 patients (22.6%), grade D – 2 patients (1.1%)
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