Place of laparoscopic surgery in the treatment of gastroesophageal reflux

: 62 patients (57 females and 5 males, mean age 42.3 years) with gastroesophageal reflux disease were treated and followed up in the A.V. Vishnevsky Institute of Surgery. The diagnosis was established at endoscopic examination, which revealed esophagitis of the 1st degree in 39 patients, of the 2nd--in 20, of the 3d--in 2 and of the 4th--in 1. Roentgenologic examination of the esophagus and the stomach revealed manifestations of the reflux in 43 patients, hernia of the esophageal orifice (of the diaphragm)--in 27. According to esophageal manometry data, basal pressure in the area of the lower esophageal sphincter made up 9.8 +/- 5.7 mm Hg; in 24-hour pH-metry the index of the De Meester exceeded normal 4-5 times and made up 61.1 +/- 33.8. All the patients have undergone a course of conservative antireflux therapy which in the majority of patients resulted in temporary improvement. Laparoscopic operations were carried out in 41 patients (fundoplication by Nissen--in 32, Toupet procedure--in 4 and--by Dor--in 5). In 23 patients cruroraphy and in 32 cholecystectomy have been performed. The patients were followed up from 1 to 36 months. In the majority of them the results were good and favourable.