[The surgical correction of the disordered sphincteric function of the cardia]

Area of Science:

• Gastroenterology
• Surgical Gastroenterology
• Surgical Innovation

Background:

• Surgical correction of the cardia is crucial for managing conditions like hiatal diaphragmatic hernia (HDH) and duodenal ulcers.
• Various surgical techniques exist, but their comparative effectiveness requires thorough evaluation.
• Accurate assessment of cardia function is essential for successful surgical outcomes.

Purpose of the Study:

• To comparatively assess different surgical methods for cardia correction.
• To evaluate the effectiveness of various surgical procedures in patients with hiatal diaphragmatic hernia and/or duodenal ulcers.
• To determine the optimal surgical approach for restoring cardia function.

Main Methods:

• Analysis of surgical treatment results in 180 patients.
• Review of procedures including Hill, Dor, N.N. Kanshin's valvular gastroplication, esophagofundorrhaphy, and modified fundoplication (N.N. Kanshin and A.F. Chernousov).
• Application of an improved fundoplication method with intraoperative esophagomanometric control in 49 patients.

Main Results:

• Fundoplication emerged as the superior method for surgical correction of the cardia.
• Modified fundoplication, especially with intraoperative esophagomanometry, demonstrated significant effectiveness.
• The study analyzed patient outcomes across different surgical interventions for cardia-related conditions.

Conclusions:

• Fundoplication is the recommended surgical procedure for cardia correction.
• Intraoperative esophagomanometry is a critical factor for achieving adequate restoration of cardia function during fundoplication.
• Optimizing surgical techniques, such as fundoplication with esophagomanometry, improves patient outcomes.