[Prevention for gastroesophageal reflux disease after gastric restriction interventions].

The article analyzed the results of surgery using tree gastric restriction laparoscopic operations which led to high possibility of the development of gastroesophageal reflux disease (GERD). Laparoscopic stomach length resection was performed in 327 (68.1%) out of 480 (62.1%) patients. Laparoscopic gastric bypass surgery took place in 142 (29.5%) cases and laparoscopic biliary-pancreatic bypass surgery--in 11 (2.3%). The diagnosis of GERD was established in 193 (40.2%) patients before the operation and it was usually accompanied by hernia of the esophageal opening (HEO). The patients were arranged in 4 groups. The first group had operations using the standard method and it included 287 (59.8%) patients without any signs of GERD or HEO. The patients of the second group (84 (17.5%) had signs of GERD and HEO and standard operations with a hernia removal and cruroraphy were carried out. The patients of the third group 109 (22.7%) had initial signs of GERD and the standard method was used for them. The developed method was applied for patients of the fourth group (132 (27.5%). All the operations were completed by antireflux valve formation, but in the cases of GERD and HEO presence, they accomplished by hernia removal, cruroraphy. After performing standard operations, the signs of GERD were noted in 51.5% of cases. Thus, patients of the first group (148 (51.5%) had the signs of GERD. It was noted, that the signs of GERD were presented in patients of the second group (79 (94%) and it numbered 97 (89%) patients of the third group. In the case of the fourth group, signs of GERD were in 14 (10.6%) patients.

[Surgical correction of dislipodemia in patients with obesity].

The results of surgical treatment of 139 patients with metabolic syndrome, obesity and dislipodemia were analyzed. Modern bariatric operations (4 types) were performed by using laparoscopic method. There were regulated bandages of the stomach (RBS), lengthwise gastric resections (LGR), biliopancreatic and stomach bypass surgeries (BBS, SBS). Results of five-year follow-up indicated that restrictive operations on the stomach (RBS, LGR) aimed to correct overweight and dislipodemia had some limitations to application in a varying degree. The RBS operation should be appropriate to use for women of the young age group, when an initial body-weight index wasn't more than 43 kg/m2. The LGR operation was effective for men of the young age group and women in case of moderately expressed dislipodemia and in case when the initial body-weight index didn't exceed more than 45 kg/m2. Combined bariatric operations (BBS, SBS) were most likely effective on body weight and dislipodemia.

[Surgical correction of damage in complex treatment of patients with metabolic syndrome].

The authors have analyzed results of treatment of 407 patients subjected to different bariatric interventions. In 359 out of them there were different bariatric operations, in 48 patients intragastric balloons were placed. Correcting plastic operations were fulfilled in 36 patients within 1-2 years after bariatric intervention. It was found that bariatric intervention fulfilled in earlier age groups would prevent the development of metabolic syndrome (MS) in patients with obesity at later date. Combined operations are most effective bariatric intervention compared with all main elements of MS. Correcting plastic operations are expedient after bariatric interventions against the background of stabilized decrease of body mass that allows getting valuable therapeutic and esthetic effect, improvement of quality of life of patients.