Stasyshyn A. Current diagnostic, clinical and pathogenic basis for the minimally invasive surgical methods in the comprehensive treatment of gastroesophageal reflux disease combined with hiatal hernia

The goal of the research was to improve the results of the surgical treatment of the gastroesophageal reflux disease associated with hiatal hearnia by development of the technique of laparoscopic antireflux surgery, algorithm of the diagnostic and treatment strategy and determination of indications for the surgical treatment, introductions of new methods of diagnosis and treatment, and improve the quality of life. The clinical part of the work was the results of retrospective and prospective studies of 537 patients with GERD and HH. A prospective study ‒ 339 patients were divided and treated in groups: 1 group - 59 patients who underwent laparoscopic fundoplication according to own original method, 2 group (77 patients) - laparoscopic Nissen fundoplication, 3 group (21 patients) - laparoscopic Toupet fundoplication, 4 group (182 patients) - complicated GERD. Immediate and long-term results of surgical treatment of patients with GERD and HH were studied. The laparoscopic surgery for hiatal hernia reduced the incidence of postoperative complications by a factor of 4, operating time by a factor of 1,4, postoperative duration of stay by a factor of 1,7. Clinical practice usage of the novel method of laparoscopic surgery reduced the incidence of GERD and hiatal hernia recurrences by a factor of 6 and a factor of 2,5 in long-term follow-up.