EARLY RESULTS OF LAPAROSCOPIC SUTURE CRUROPLASTY AND NISSEN FUNDOPLICATION IN PATIENTS WITH HIATAL HERNIA AND REFLUX ESOPHAGITIS

Öz

The aim of study is to analysis the early results and effectiveness of laparoscopic primary crus repair and antireflux surgery, and to guide clinicians in the selection of surgical candidates and methods. Between June 2013 and June 2018, the data of patients who were operated due to hiatal hernia and reflux esophagitis were reviewed retrospectively. All patients were evaluated with manometry, 24-hour pH monitorization and en- doscopy before surgery. Routine endoscopic control was performed at postoperative 6th month. Demo- graphic characteristics, preoperative and postoperative endoscopy findings, and complications were recorded. Eighteen (56.2%) of the patients were male and 14 (43.8%) were female. Early complications were observed in 6 (18.8%) patients. Esophagitis was not observed in 28 (87.5%) of the patients at the endoscopic controls performed at the postoperative 6th month. According to the Los Angeles classification, esophagitis, which was preoperative grade C, decreased to grade A in 3 (9.4%) patients. In 1 (3.1%) patient, esophagitis persisted at the same severity as the preoperative period. At the end of the 6th month, none of the patients had dysphagia and recurrence. The combination of laparoscopic suture cruroplasty and Nissen fundoplication was found to be an effective treatment in terms of early complications and recurrence rates, as well as the treatment of esophagitis in hiatal hernia patients with reflux esophagitis.

Anahtar Kelimeler

• hiatal hernia
• reflux esophagitis
• Nissen fundoplication
• suture cruroplasty
• laparoscopy

HİATAL HERNİ VE REFLÜ ÖZOFAJİT BİRLİKTELİĞİNDE LAPAROSKOPİK SÜTÜR KRUROPLASTİ VE NİSSEN FUNDOPLİKASYONU’NUN ERKEN DÖNEM SONUÇLARI

Öz

Bu çalışmanın amacı laparoskopik primer krus onarımı ve antireflü cerrahisinin erken dönem sonuçlarını ve etkinliğini irdelemek, cerrahi tedaviye aday hastalar ve yöntem seçiminde klinisyenlere yol gösterici olmaktır. Haziran 2013 ile Haziran 2018 tarihleri arasında hiatal herni ve reflü özofajit birlikteliği nedeni ile ameliyat edilen hastaların verileri retrospektif olarak tarandı. Tüm hastalar ameliyat öncesinde özofagus manometrisi, 24 saatlik pH monötörizasyonu ve üst gastrointestinal sistem endoskopisi ile değerlendirildi. Ameliyat sonrası 6. ayda rutin endoskopik kontrol yapıldı. Hastaların demografik özellikleri, ameliyat öncesi ve sonrası endoskopi bulguları ve peroperatif komplikasyonlar kayıt altına alındı. Hastaların 18'i (%56.2) erkek, 14'ü (% 43.8) kadındı. Altı (%18.8) hastada erken komplikasyon izlendi. Postoperatif 6. ayda yapılan endoskopik kontrollerde hastaların 28'inde (%87.5) özofajit görülmedi. Üç hastada (%9.4) Los Angeles sınıflandırmasına göre preoperatif grade C olan özofajitin grade A'ya gerilediği görüldü. Bir  (%3.1) hastada özofajit preoperatif dönem ile aynı şiddetde sebat etmekteydi.  Altıncı ayın sonunda hiçbir hastada disfaji ve rekürrens saptanmadı. Laparoskopik sütür kruroplasti ve Nissen fundoplikasyonu kombinasyonu reflü özofajiti olan hiatal herni hastalarında özofajitin tedavisi yanı sıra erken dönem komplikasyon ve rekürrens oranları yönünden de etkin bir tedavi olduğu görüldü.

Anahtar Kelimeler

• hiatal herni
• reflü özofajit
• Nissen fundoplikasyonu
• sütür kruroplasti
• laparoskopi

Kaynakça

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