Paranyak M. Effectiveness of laparoscopic fundoplications in the treatment of extraesophageal manifestations of gastroesophageal reflux disease

The dissertation is devoted to the study of the effectiveness of laparoscopic fundoplications and conservative therapy in the treatment of extraesophageal manifestations of gastroesophageal reflux disease. It has been established that the laparoscopic Nissen fundoplication, in comparison with the Toupet method, is a more effective treatment procedure for patients with extraesophageal manifestations of gastroesophageal reflux disease. A new method of performing laparoscopic fundoplication was proposed for the first time, which is a highly effective method avoiding the occurrence of the slippage wrap syndrome. It was found out for the first time that the new technique of laparoscopic fundoplactations is a significantly more effective method in comparison with conservative therapy of treatment of otorhinolaryngological, respiratory, and cardiac manifestations of gastroesophageal reflux disease. The technique of performing laparoscopic Nissen fundoplication was improved , which minimizes the risk of postoperative complications and reduces the proportion of patients requiring repeated surgical interventions. Fundoplications performed according to the new technique allow to achieve a more remarkable effect compared with the standard antireflux conservative therapy schemes in the treatment of extraesophageal manifestations of gastroesophageal reflux disease. It was found that the positive effect of drug treatment is not stable and decreases over time, while the laparoscopic fundoplications provides elimination or a significant reduction in the symptoms of the disease and improvement of the quality of life for at least 24 months.