SURGICAL TACTICS FOR LARGE AND GIANT ESOPHAGEAL HIATAL HERNIA

Abstract

The OBJECTIVE is to improve the results of surgical treatment of patients with large and giant EHH. MATERIAL AND METHODS. We present our experience of surgical treatment of 25 patients with large and giant EHH, who underwent laparoscopic interventions according to the original technique, which consisted in the method of plasty of esophageal hiatus: the mesh implant was installed and fixed in the posterior mediastinum above the diaphragm. RESULTS. Intraoperative bleeding was noted in 2 (8 %) patients, which did not require conversion. In the near postoperative period, no complications were noted. In the long-term periods from 1 to 5 years, there was no recurrence of EHH and complications associated with the use of mesh implant. CONCLUSION. Videoendosurgical interventions are the operations of choice in the treatment of patients with large and giant EHH. The most effective method of plasty for large and giant EHH is the combined plasty of the esophageal hiatus by a mesh implant in combination with a posterior cruroraphy, with the installation and fixation of the mesh implant in the posterior mediastinum above the cruses of diaphragm.

Keywords

• giant esophageal hiatal hernia
• mesh implant
• plasty of the esophageal hiatus
• surface area of the esophageal hiatus