OBJECTIVE
To study the results of videolaparoscopic antireflux intervention for GERD in patients with HH based on the integral quality of life index using special and general questionnaires.
MATERIAL AND METHODS
213 patients with axial hiatal hernia in combination with GERD were surveyed before surgery and within 6 to 12 months after surgery using three questionnaires (GERD-HRQL, GIQLI, SF-36). According to the results of the questionnaire, the patients were divided into 2 groups. The first group included patients with symptoms of GERD (141 people, 66.2%), the second group — without clinical manifestations of disease recurrence (72 people, 33.8%). Based on special research methods, patients of the first group were divided into two subgroups — with false positive symptoms of GERD and with determined disease recurrence. To assess the results of surgical treatment according to the questionnaire data using special and general questionnaires, an integral quality of life index was developed, which in the absence of GERD is 1.
RESULTS
The Integral quality of life index before antireflux surgery among all observed patients averaged 0.43, which was 57±3.39% less than the desired result. In the long-term terms of antireflux surgery in patients with false positive symptoms of GERD, the Integral quality of life index was 0.88, which is more than 2 times better than preoperative results and 12±2.94% lower than the maximum possible desired result. In a subgroup of patients with recurrent GERD, the Integral quality of life index after surgery was 0.67, which is 59.5±6.8% better than preoperative results, but 33±6.8% lower than the maximum possible desired result. In patients without symptoms of recurrent GERD, according to the results of the questionnaire, the IQLI was 0.93, which is 111.4±4.6% better than preoperative results (p<0.05) and was only 7±4.6% lower than the maximum possible desired result. At the same time, the IQLI in patients with recurrent GERD was 23.9±4.2% (p<0.001) less than in patients with false positive symptoms of GERD and 27.9±4.2% (p<0.001) less than in the group of patients without recurrent GERD.
CONCLUSION
The Integral quality of life index in the long term after videolaparoscopic antireflux surgery for GERD in combination with HH allows for the primary screening diagnosis of disease recurrence and identification of patients (risk group) with some signs of GERD without confirming the recurrence of the disease by special methods of studying the antireflux function of the cardia.
