Shkvarkovskyi I. Multimodality surgical treatment of gastroesophageal reflux desease

The thesis deal with solving the problem of diagnosing and treating patients with gastroesophageal reflux disease. The obtained findings as a resulthe of a topographo-anatomical study have made it possible to develop a new mode of correcting gastroesophageal reflux disease and hiatal hernia. The efficacy of the elaborated experimental model has been corroborated by the histopathological and biochemical signs of reflux-esophagitis. An experimental use of the elaborated complex method of corecting gastroesophageal reflux disease has enabled to eliminate effectively gastroesophageal reflux and that was proved by histopathological and biochemical studies of the biopsy materials of the esophagogastric junction. A diagnostic-medical algorithm has been developed on the basis of the results of a retrospective analisis that has made it possible to systematise the principal and extraesophageal manifestation of the disease, determine the most complete diagnostic program and choose an optimal therapeutic approach. The clinical part of the research included the results of an examination and treatment of 305 patients afflicted with gastroesophageal reflux disease. A comparative analysis of the efficacy of different methods of treatment has been carried and postfundoplication complications have been studied on the basis of the results of treating the patients of the first group. A clinical application of the elaborated method of invaginating esophagogastroplication with hiatal hernia plastic repair modelled by a polymer implant has been carried uot in the second group of patients and that has made it possible to avoid typical postfundoplication complications and shoten the hospital stay.