Surgical aspects of repeat antireflux interventions for recurrent reflux esophagitis and hiatal hernia

Shestakov AL, Yurasov AV, Bitarov TT, et al. . Surgical aspects of repeat antireflux interventions for recurrent reflux esophagitis and hiatal hernia. Russian Journal of Evidence-Based Gastroenterology. 2024;13(3):20‑25. (In Russ.)
https://doi.org/10.17116/dokgastro20241303120

Подписка 2025 (Russian Journal of Evidence-Based Gastroenterology)

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OBJECTIVE

To evaluate the mechanisms of gastroesophageal reflux disease (GERD) and hiatal hernia recurrence after antireflux surgeries.

MATERIAL AND METHODS

Twenty-seven patients with recurrent hiatal hernia and GERD were operated on, following standard diagnostic and therapeutic principles. Indications for repeat surgery included disease recurrence, defined as the development of a hernia and the recurrence of reflux esophagitis symptoms, confirmed by endoscopy. All patients underwent redo fundoplication using the method developed by the Research Institute of Clinical and Experimental Surgery (RNTSKh).

RESULTS

Positive outcomes, with the disappearance of reflux esophagitis symptoms following the repeat antireflux surgery, were achieved in 24 patients (88.8%). The main mechanisms of GERD and hiatal hernia recurrence after antireflux surgeries were evaluated.

CONCLUSION

When selecting the method for correcting recurrent hiatal hernia, it is essential to consider increased intra-abdominal pressure, the degree of esophageal shortening, and the level of the esophagogastric junction and cardia relative to the diaphragmatic crura.

Keywords:

gastroesophageal reflux

hiatal hernia

peptic esophagitis

fundoplication

reoperation

Authors:

Shestakov A.L.

Petrovsky National Research Center of Surgery;
Sechenov First Moscow State Medical Univesity

ORCID: 0000-0001-7061-6298

Yurasov A.V.

Petrovsky National Research Center of Surgery

ORCID: 0000-0003-3091-7402

Bitarov T.T.

Petrovsky National Research Center of Surgery

ORCID: 0000-0002-0484-5022

Boeva I.A.

Petrovsky National Research Center of Surgery

ORCID: 0000-0003-2646-0729

Tskchovrebov A.T.

Petrovsky National Research Center of Surgery

ORCID: 0000-0002-4445-2530

Tarasova I.A.

Petrovsky National Research Center of Surgery;
Sechenov First Moscow State Medical Univesity

ORCID: 0000-0001-9344-7351

Afanasyev D.V.

Smolensk State Medical University

ORCID: 0000-0002-7474-3873

Moskvin A.A.

Petrovsky National Research Center of Surgery

ORCID: 0009-0003-9108-7972

Received:

10.06.2024

Accepted:

25.06.2024

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