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  Česky / Czech version Endoskopie, 2006, 15, č. 1, s. 8–12
 
Laparoscopic hiatoplasty and fundoplication: retrospective analysis in 2000–2003 
Marko Ľ.1, Molnár P.1, Marková I.2, Koreň R.1 

1Oddelenie miniinvazívnej chirurgie a endoskopie, FNsP FD Roosevelta, Banská Bystrica, primár MUDr. Ľubomír Marko 2Rádiodiagnostické oddelenie, FNsP FD Roosevelta, Banská Bystrica, primár MUDr. Stanislav Okapec
 


Summary:

       Gastroesophageal reflux dissease is very frequent diagnosis with increased trend in present population. In patients population where conservative tretment failed is indicated surgical therapy. The gold standard represents laparoscopic fundoplication with hiatoplasty. In our department more than 320 laparoscopic hiatoplasties and fundoplications in patients with clinically proven signs of the gastroesophageal reflux (GER) and with or without presence of hiatal hernia were performed. There were 2 times (0,62%) conversions to open operation, 1 times (0,3%) urgent reoperation for acute bleeding and 7 times (2,2%) reoperation for rupture of hiatoplasty or fundoplication valve. The authors present retrospective analysis of the operations made within 2000–2003, when operating surgeon (LM) made 140 operations for above mentioned diagnosis. All patients were reviewed using questionnaire. 70% patients sent back the fullfilled questionnaire (98 from 140 patients). Before operation all patients had heartburn within 0,5–45 years (range 10–11 years), the diagnosis was made within 6 months till 20 years before operation (range 4 years). All patients were examined by endoscopy 1–50 times (range 8 time before surgery), medical therapy was used before operation within 6 months till 40 years (range 4–5 years), 43 times was diagnosed inflammatory disease of the esophagus by endoscopy. Radiodiagnostic examinations were made in 52 cases, pH-metry 10 times, manometry 4 times. After operation dysphagia was present within some weeks to 1 year (25% of patients within 1 month), 4 patients have mild degree od permanent dysphagy. After operation 61 patients (62,2%) consider quality of the life themselves as a perfect one, 29 patients (29,6%) are satisfied with (sometimes) minimal signs of heartburn and 8 patients (8,2% of all) are not satisfied from various reasons.

        Key words: gastroesophageal reflux, hiatal hernia, laparoscopic fundoplication, postoperative quality of life
       

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