Ways to improve the results of laparoscopic antireflux operations in patients with big hiatal hernias
Journal Title: Медичні перспективи - Year 2018, Vol 23, Issue 4
Abstract
The purpose of our study is to evaluate expediency of Platelet-Rich Plasma with self-fixated ProgripTM mesh use in hiatal hernia repair. The study was performed on 144 patients with gastroesophageal reflux with large hiatal hernias (the size of hernias 10-20 cm2 ), who underwent Nissen fundoplication and crurarrhaphia. All patients were divided into two groups: I group (71 patients) - we used non-absorbable self-fixating ProgripTM mesh for reinforcement of crurarrhaphia, II group (73 patients) – crurarrhaphia was done without mesh. In the patients of I group pieces of mesh were infiltrated by 2-4 ml of autologous PRP. Follow-up was completed in 128 (88,9%) patients with a mean follow-up duration of 39 months (range 12-60 months). There were no serious complications in the patients of both groups. During the 60 months of follow-up, 2 recurrences occurred in the mesh group and 14 recurrences appeared in the non-mesh group (p<0.05). Patient satisfaction was significantly higher in the mesh group (p<0.05). Our study has shown that the collagen content is reduced in patients with large HH. Thus, in such patients it is advisable to use mesh for crural reinforcement. The use of PRP provides a fast ingrowth of mesh, acts as catalyst to increase collagen synthesis and deposition, which promote to reduce the risk of recurrences.
Authors and Affiliations
V. V. Hrubnik, M. R. Paraniak
Keywords
Related Articles
- EP ID EP439525
- DOI 10.26641/2307-0404.2018.4.152995
- Views 98
- Downloads 0
Порушення внутрішньосерцевої гемодинаміки у дітей з хронічною ревматичною хворобою серця
С помощью допплерэхокардиографии изучены нарушения внутрисердечной гемодинамики у 44 детей в возрасте от 8 до 17 лет с хронической ревматической болезнью сердца и сформированными митральным, аортальным и комбинированными...
The prevalence and intensity of the main dental diseases in children of Simferopol
At present, despite the availability of modern effective oral hygiene means and prevention of dental diseases, which reduced their intensity, disease prevalence remains high. One method of dental caries preventing in chi...
Критерії діагностики стану морфологічно розподілених стовбурових регуляторних структур при цереброваскулярних захворюваннях
Проведено клинико-нейрофизиологическое исследование 62 пациентов, которые переносили субтенториальный ишемический инсульт для определения критериев нарушения функции морфологически распределенных стволовых регуляторных с...
Association between atopic and non-atopic diseases at children
The paper presents the data of the association analysis between the diseases composig the atopic march (AM) in children – atopic dermatitis (AD), seasonal rhinoconjunctivitis (SARC) and perennial allergic rhinitis (PAR)...
Удосконалення системи забезпечення гемотрансфузійними препаратами Збройних Сил України
Совершенствование системы обеспечения гемотрансфузионными препаратами Вооруженных сил Украины. Замковый А.Д., Тимченко А.С. Представлены результаты исследований, обосновывающие систему гемотрансфузиологичного обеспечения...