[Surgical treatment of hiatal hernia complicated by short esophagus: a prospective study]. / Khirurgicheskoe lechenie gryzh pishchevodnogo otverstiya diafragmy, oslozhnennykh korotkim pishchevodom.

OBJECTIVE: To analyze immediate and long-term postoperative results in patients with hiatal hernia complicated by short esophagus. MATERIAL AND METHODS: We prospectively analyzed postoperative outcomes in 113 patients with hiatal hernia who underwent surgery between 2013 and 2021. The main group consisted of 54 patients with length of intra-abdominal segment of esophagus <4 cm who underwent Collis procedure or esophagus >4 cm and indications for Nissen fundoplication cuff. The control group consisted of 59 patients and indications for esophageal lengthening procedure only if length of intra-abdominal segment of esophagus was less than 2 cm. This surgery was started with anterolateral vagotomy, and Collis procedure was performed in case of ineffective vagotomy. Nissen fundoplication was performed for abdominal segment of esophagus >2 cm. RESULTS: In the main group, 17 (31.5%) patients with intra-abdominal segment of esophagus <4 cm required Collis procedure. In the control group, length of intra-abdominal segment of esophagus <2 cm was observed in 6 (10.2%) patients. In all cases, anterolateral vagotomy was performed. Surgery time was 189 (80-290) and 136 (90-320) min, respectively (p=0.001). Postoperative complications in the main group occurred in 8 (14.8%) patients, in the control group - 4 (6.8%) patients (p=0.281). One (1.7%) patient died in the control group. The follow-up period was 38 (12-66) months. In long-term period, recurrence developed in 2 (3.7%) and 11 (20%) patients, respectively (p=0.026). High satisfaction with postoperative outcomes was observed in 51 (94.4%) and 46 (79.3%) patients, respectively (p=0.038). CONCLUSION: Uncorrected shortening of the esophagus can be one of the main risk factors of recurrence in long-term period. Expanding the indications for Collis gastroplasty can reduce the incidence of poor outcomes without affecting the incidence of postoperative complications.

[CRITERIONS OF EFFICACY OF THE SOFT TISSUES ELECTRIC WELDING FOR THE HEMOSTASIS GUARANTEEING IN LAPAROSCOPIC OPERATIONS].

Possibilities of application of generator for electric welding of soft tissues, used for hemostasis in laparoscopic operations, were studied. There was established, that while doing laparoscopic operation a biological welding of tissues secures a safe intra- and postoperative hemostasis, reduction of intra- and postoperative morbidity rate.