PREVENTION FOR GASTROESOPHAGEAL REFLUX DISEASE AFTER GASTRIC RESTRICTION INTERVENTIONS

Abstract

The article analyzed the results of surgery using tree gastric restriction laparoscopic operations which led to high possibility of the development of gastroesophageal reflux disease (GERD). Laparoscopic stomach length resection was performed in 327 (68,1%) out of 480 (62,1%) patients. Laparoscopic gastric bypass surgery took place in 142 (29,5%) cases and laparoscopic biliary-pancreatic bypass surgery - in 11 (2,3%). The diagnosis of GERD was established in 193 (40,2%) patients before the operation and it was usually accompanied by hernia of the esophageal opening (HEO). The patients were arranged in 4 groups. The first group had operations using the standard method and it included 287 (59,8%) patients without any signs of GERD or HEO. The patients of the second group (84 (17,5%) had signs of GERD and HEO and standard operations with a hernia removal and cruroraphy were carried out. The patients of the third group 109 (22,7%) had initial signs of GERD and the standard method was used for them. The developed method was applied for patients of the fourth group (132 (27,5%). All the operations were completed by antireflux valve formation, but in the cases of GERD and HEO presence, they accomplished by hernia removal, cruroraphy. After performing standard operations, the signs of GERD were noted in 51,5% of cases. Thus, patients of the first group (148 (51,5%) had the signs of GERD. It was noted, that the signs of GERD were presented in patients of the second group (79 (94%) and it numbered 97 (89%) patients of the third group. In the case of the fourth group, signs of GERD were in 14 (10,6%) patients.