Experience in treatment of diaphragm hernias

2020 
Hernias of the diaphragm are a common pathology that negatively affects the quality of life of patients and in some cases requires high-quality surgical correction. This pathology has a progressive course, which leads to an increase in the severity of clinical manifestations with the age of the patient. The article presents the experience of surgical treatment of hernias of the diaphragm on the basis of general surgery clinics of the military medical academy. The aim of the study is to determine the effectiveness of surgical treatment of hernias of the diaphragm in different categories of patients. The total number of treated patients was 216. All patients were operated on. Thirty-four patients underwent a sympultal laparoscopic cholecystectomy. The operation used laparoscopic access. The closest excellent and good results of clinical treatment occurred in 92% of cases, satisfactory and unsatisfactory results accounted for 5.4 and 2.7%, respectively. According to the results of the instrumental survey, 40.6 and 54%, respectively, achieved excellent and good results; Satisfactory and unsatisfactory — 2.7 and 2.7%. The introduction of laparoscopic techniques in surgery has reduced the number of early and late post-operative complications in the treatment of hernias of the diaphragm. The recommendations of the American Association of Endoscopic Surgeons for the operational treatment of gastroesophageal reflux disease shows the positive effect of laparoscopic fundoplications in 85–93% of patients whose medicinal therapy has proved ineffective. In general, the results of the immediate and long-term outcomes of the surgical treatment of hernias of the diaphragm at the General Surgery Clinic of Military Medical Academy showed similar results (8 figs, bibliography: 16 refs).
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