Prestenotic dilation of proximal parts of stomach as a predictor for development of gastro-esophageal reflux in late period after laparoscopic gastroplication

Keywords: оbesity; matabolic syndrome; laparoscopic gastroplication; reflux-esophagitis.

Abstract

Objective. Estimation of immediate and late results of laparoscopic gastroplication (LGP) and analysis of predictors of unfavorable outcomes of bariatric operation.

Маterials and methods. The investigation was conducted on background of results of examination and surgical treatment on 79 patients, suffering obesity and metabolic syndrome, to whom LGP was accomplished on the cathedral bases of the Shupyk NMAPE Department of Surgery and Vascular Surgery in 2015 - 2018 yrs.

Results. In accordance to secondary investigations, done in one year after the operative intervention, the body mass index lowering/ improvement of the glycemia and lipidogram indices, as well as the arterial pressure normalization and reduction of the apnoe rate while sleeping were registered. In accordance to data of secondary roentgenoscopy with contrasting of the foregut, conducted in 6 mo after LGP, in 20 (25.3%) patients irregular narrowing of a gastric tube higher than gastric angle was registered. In 12 mo roentgenological signs of significant widening of the gastric tube, formatted of fundus and cardia were seen, as well as the angle of His enhancement, presence of gastro-esophageal reflux of the contrast, аnd 2 patients have had the signs of axial cardial hiatal hernia. Simultaneously in 20.2% patients the symptoms of gastro-esophageal reflux disease with essential lowering of the patients’ quality of life were observed.

Conclusion. LGP constitutes a potentially secure and effective bariatric operation, after which the body mass reduces significantly and constantly. But in 20.2% patients the morbidity occur: through 12 mo after the operation GERD and reflux-esophagitis evolves. The origin of this late complications is a partial stenosis in the gastric angle region, what causes the development of prestenotic dilation of proximal gastric parts.

Author Biographies

S. I. Savolіuk, Shupyk National Medical Academy of postgraduate Education, Kyiv

Savoliuk S.I. - MD, Doctor of Sci (Med), Professor,
Head of Department of Surgery and Vascular Surgery.
Shupyk National Medical Academy of Postgraduate Education
9, Dorogojitska street, 04112, Kiev, Ukraine
https://orcid.org/0000-0001-5406-8228
savoluk@meta.ua
+380679894283

V. M. Lysenko, Shupyk National Medical Academy of postgraduate Education, Kyiv

Lysenko V.M.- MD, K of Sci (Med), Docent
Department of Surgery and Vascular Surgery
Shupyk National Medical Academy of Postgraduate Education
9, Dorogojitska street, 04112, Kiev, Ukraine
https://orcid.org/0000-0001-7327-3710
2291438@gmail.com
+380506848137

М. Yu. Кrestіanov, Shupyk National Medical Academy of postgraduate Education, Kyiv

Krestianov M.Y. - MD, K of Sci (Med), Assistant
Department of Surgery and Vascular Surgery
Shupyk National Medical Academy of Postgraduate Education
9, Dorogojitska street, 04112, Kiev, Ukraine
https://orcid.org/0000-0003-4529-5036
krestianov@ukr.net
+380997113719

D. S. Zavertylenko, Shupyk National Medical Academy of postgraduate Education, Kyiv

Zavetylenko D.S.- MD, Aspirant
Department of Surgery and Vascular Surgery
Shupyk National Medical Academy of Postgraduate Education
9, Dorogojitska street, 04112, Kiev, Ukraine
zavertuha@gmail.com
https://orcid.org/0000-0002-5832-1507
zavertuha@gmail.com
+380668080426

А. Yu. Glagolіeva, Shupyk National Medical Academy of postgraduate Education, Kyiv

Glagolieva A.Y. Krugliak Y.K. - MD, Aspirant
Department of Surgery and Vascular Surgery
Shupyk National Medical Academy of Postgraduate Education
9, Dorogojitska street, , 04112, Kiev, Ukraine
https://orcid.org/0000-0003-1256-7277
nglagoleva90@gmail.com
+380637618003

E. К. Кruglіak, Shupyk National Medical Academy of postgraduate Education, Kyiv

Krugliak Y.K. - Intern Department of Surgery and Vascular Surgery
Shupyk National Medical Academy of Postgraduate Education
9, Dorogojitska street, , 04112, Kiev, Ukraine
https://orcid.org/0000-0002-0512-9589
drmanny60@gmail.com
+380679600901

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Published
2019-05-05
How to Cite
SavolіukS. I., Lysenko, V. M., КrestіanovМ. Y., Zavertylenko, D. S., GlagolіevaА. Y., & КruglіakE. К. (2019). Prestenotic dilation of proximal parts of stomach as a predictor for development of gastro-esophageal reflux in late period after laparoscopic gastroplication. Klinicheskaia Khirurgiia, 86(5), 8-11. https://doi.org/10.26779/2522-1396.2019.05.08
Section
General Problems of Surgery