COMPLEX APPROACH IN DIAGNOSTICS AND TREATMENT OF GASTROESOPHAGEAL REFLUX DISEASE COMPLICATED BY METAPLASIA
The treatment results of 34 patients with GERD complicated by metaplasia of the esophageal mucosa were analyzed. According to the pathomorphological conclusion, 19 (55.9 %) had intestinal metaplasia, in 9 (26.5 %) founded gastric metaplasia, in the remaining 6 cases - low-grade dysplasia against the background of intestinal (4) and gastric (2) metaplasia. After provided diagnosis verification, conservative therapy and antireflux surgery, the patient underwent argon-plasma coagulation, depended from the maximum length of the circular segment of metaplasia. There were no complications, associated with argon-plasma coagulation procedures. In the long-term period, all patients showed regeneration of metaplasia areas with healthy tissue. In observation during 6 years, there were no patient had a relapse of the disease. The basis for the successful treatment is an integrated approach, and the developed technique of argon-plasma coagulation, that allows to avoid the esophageal strictures and to achieve the regression of metaplasia of the esophageal mucosa.