Sovpel I V, Ishchenko R V, Sedakov I E, Sovpel O V, Balaban V V
Gorky Donetsk National Medical University, Donetsk, Ukraine.
Bondar Republican Oncology Center, Donetsk, Ukraine.
Khirurgiia (Mosk). 2021(6):30-37. doi: 10.17116/hirurgia202106130.
To analyze the early and long-term postoperative outcomes after Collis gastroplasty in the treatment of patients with hiatal hernia complicated by gastroesophageal reflux disease and shortening of the esophagus.
Postoperative outcomes after Collis gastroplasty were analyzed in 22 patients with hiatal hernia and shortening of the esophagus. The control group consisted of 166 patients after simple repair of hiatal hernia without Collis procedure.
In case of Collis gastroplasty, surgery time was 185 (160-250) min. Intraoperative complications were observed in 3 (13.6%) patients, incidence of postoperative complications - 18.2%. There were no lethal outcomes in this group of patients. Mild functional dysphagia was observed in 2 (9.1%) patients. Length of hospital stay was 7.8±2.4 days. Mean follow-up was 34 (6-52) months. There were no anatomical recurrences. A relapse of gastroesophageal reflux was noted in 1 (4.6%) case. GERD-HRQL score was 4.8±2.2 points. Additional Collis gastroplasty did not affect the immediate and long-term results of surgical treatment in comparison with simple cruroraphy and fundoplication.
Unreduced shortening of the esophagus may be followed by high incidence of recurrent hiatal hernia and GERD in long-term period. In case of shortening of the esophagus, surgery should include Collis gastroplasty. This effective and safe procedure does not impair treatment outcomes. Indications and optimal technique of Collis gastroplasty require clarification and further research.
分析科利斯胃成形术治疗食管裂孔疝合并胃食管反流病及食管缩短患者的早期和长期术后结局。
分析22例食管裂孔疝合并食管缩短患者行科利斯胃成形术后的结局。对照组由166例单纯行食管裂孔疝修补术而未行科利斯手术的患者组成。
行科利斯胃成形术时，手术时间为185（160 - 250）分钟。3例（13.6%）患者出现术中并发症，术后并发症发生率为18.2%。该组患者无死亡病例。2例（9.1%）患者出现轻度功能性吞咽困难。住院时间为7.8±2.4天。平均随访34（6 - 52）个月。无解剖学复发。1例（4.6%）出现胃食管反流复发。胃食管反流病健康相关生活质量（GERD - HRQL）评分为4.8±2.2分。与单纯食管裂孔修补术和胃底折叠术相比，附加科利斯胃成形术不影响手术治疗的近期和长期效果。
食管未复位的缩短可能导致长期食管裂孔疝复发和胃食管反流病的高发生率。若存在食管缩短，手术应包括科利斯胃成形术。这种有效且安全的手术不影响治疗效果。科利斯胃成形术的适应证和最佳技术需要进一步明确和研究。
