Prevention of postoperative complications after NISSEN fundoplication in patients with hiatal hernia

Objective: to improve the effectiveness of surgical treatment of hiatal hernia (HH) by timely prevention of complications associated with Nissen fundoplication.

Material and methods: the study included 140 patients with НН who were divided into two groups. The control group consisted of 67 patients who underwent traditional laparoscopic Nissen fundoplication combined with cruroplasty (hiatal crural repair). The study group consisted of 73 patients, who underwent a modified technique of laparoscopic Nissen fundoplication with cruroplasty, and the use of a composite mesh implant. The study group also underwent proprietary procedures for preventing early postoperative complications were implemented, that allowed for a more complete assessment of their impact on treatment outcomes.

Results: in the study group, early postoperative complications of varying severity occurred in 12 (16.4%) patients: dysphagia - in 4, reflux esophagitis grade A - in 7 cases, postoperative pneumonia - in 1 case. In the control group, after standard laparoscopic Nissen fundoplication with cruroplasty, early postoperative complications were noted in 29 (43.3%) cases: early dysphagia in 13 (19.4%) cases, failure of the fundoplication cuff in 2 (3.0%) cases, reflux esophagitis grades A and B in 12 (17.9%) cases, postoperative pneumonia in 2 (3.0%) cases.

Conclusion: the study results confirm that implementation of the proposed preventive measures reduces the risk of mechanical dysphagia after surgery. Therefore, the proposed approach can be considered an effective strategy for preventing these postoperative complications. 

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