A new method of diagnosis of the hiatal hernia associated with gastroesophageal reflux disease.

OBJECTIVE: Introduction: Gastroesophageal reflux disease (GERD) is one of the most common gastroduodenal diseases. The relationship between the hiatal hernia and the GERD is established. It is advisable to develop an accessible non-invasive diagnostic method for this combined pathology. The aim of the research was to estimate measuring of calcium in patients' saliva samples as simple non-invasive diagnostic method of GERD associated with the hiatal hernia. PATIENTS AND METHODS: Materials and methods: The samples of saliva were obtained from 37 patients with hiatal hernia associated with GERD and 22 healthy volunteers. The content of calcium in saliva was measured using calcium-sensitive dye Arsenazo III by photometrical method at a wavelength of 590-650 nm. RESULTS: Results: It has been established that in the saliva of patients with hiatal hernia, the calcium content was increased by 100.9% compared to the control group. Such a significant increase in the level of calcium in the saliva of patients with hiatal hernia may be due to the fact that the development of this pathology is a disorder of calcium homeostasis. CONCLUSION: Conclusions: It has been found that the calcium content in the saliva of patients with hiatal hernia exceeded the norm almost twice. Thus, the determination of calcium content in saliva can be used as a simple non-invasive diagnostic marker of hiatal hernia associated with GERD.

Gastroesophageal reflux disease: the results of videolaparoscopic fundoplication at five years after surgery.

INTRODUCTION: GERD reduces social activity and significantly affects the quality of life (QOL) of patients and the risk of complications (cancer of the esophagus, esophageal-gastric bleeding, strictures, perforation) is one of the most pressing problems of medicine of XXI century. The aim of the research is to evaluate the results of videolaparoscopic fundoplication at five years after surgery in patients with gastroesophageal reflux disease. MATERIAL AND METHODS: We studied results of videolaparoscopic antireflux surgery (VLAS) during 2009-2016 years in Department of Surgery and Endoscopy Faculty of postgraduate medical education Lviv National Medical University. We have gathered the group of 195 patients who underwent VLAS. RESULTS: Among the complications of GERD, Barrett's esophagus was diagnosed in 9 (19.6 %), peptic ulcer of the esophagus in 10 (21.7 %), peptic stricture of the esophagus in 4 (8.7 %), esophageal-gastric bleeding in 23 (50.0 %) patients, including Malory-Weiss syndrome in 18, erosive ulcerous bleeding in 5 people. In 176 (90.2 %) patients completed Nissen fundoplication, in 14 (7.2 %) - Toupe, 5 (2.6 %) - Dor fundoplication. We use standart surgical techniques. The mean operative time was 95±25,2 minutes. In 2 patients after surgery capnothorax on left side had occurred and treated. The mean hospital stay was 3±2,4 days. There were no serious complications in the time of surgery and after it, as well as no conversions or repeated antireflux surgeries at five years after surgery. CONCLUSION: Videolaparoscopic antireflux surgery for GERD is an equally effective alternative to medical therapy and should be offered to appropriately selected patients by skilled surgeons.