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