EXPERIENCE OF THE A.G. SAVINYKH CLINIC IN THE TREATMENT OF PATIENTS WITH REFLUX ESOPHAGITIS AT HIATAL HERNIA
The paper presents the results of surgical treatment of 38 patients with hiatal hernia when applying cardiopexy by the Rampal-Narbona method. This operation involves the use of a round ligament of liver to recreate the acute angle of His and to fix cardia and esophagus in the abdominal cavity. There were no fatal cases. Postoperative complications were observed in patients over 60 years old and were not associated with the underlying disease. Repeated examination in the period from 10 to 18 months after surgery recorded two cases (5.3%) of hiatal hernia and five cases (13.2%) of relapse of reflux esophagitis. In three (7.9%) patients with Barrett's esophagus, there was no negative dynamics in the form of an increase in the length of focal metaplasia and an increase in the degree of dysplasia. The obtained results demonstrate both the limited efficiency of cardiopexy by the round ligament of liver. This technique can be used in clinical practice after further improvement consisting in the increase of mechanical properties by the round ligament of liver.