Діагностика та лікування gas-bloat синдрому після антирефлюксної хірургії

O. S. Tyvonchuk; I. S. Tereshkevych; R. I. Vynohradov; D. Yu. Zhytnik

doi:10.14739/2310-1210.2022.3.239013

Authors

O. S. Tyvonchuk SI “Shalimov’s National Institute of Surgery and Transplantation” of the National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine https://orcid.org/0000-0002-6835-891X
I. S. Tereshkevych SI “Shalimov’s National Institute of Surgery and Transplantation” of the National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine https://orcid.org/0000-0001-6761-956X
R. I. Vynohradov SI “Shalimov’s National Institute of Surgery and Transplantation” of the National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine https://orcid.org/0000-0002-4204-4744
D. Yu. Zhytnik SI “Shalimov’s National Institute of Surgery and Transplantation” of the National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine https://orcid.org/0000-0001-5862-3575

DOI:

https://doi.org/10.14739/2310-1210.2022.3.239013

Keywords:

gas-bloat syndrome, hiatal hernia, Nissen fundoplication, Toupet fundoplication, gastroesophageal reflux disease

Abstract

The aim of the study was to assess the frequency of complications after laparoscopic Nissen fundoplication in patients with a hernia of the esophageal orifice of the diaphragm, to determine the features of diagnosis and treatment of gas-bloat syndrome.

Materials and methods. According to the results of the meta-analysis, 10 % of patients with esophageal hiatal hernia developed inability to belch, 19 % – gas-bloat syndrome, 59 % – flatulence after laparoscopic Nissen fundoplication.

The treatment results of two patients with gas-bloat syndrome at the SI “Shalimov’s National Institute of Surgery and Transplantation” of the National Academy of Medical Sciences of Ukraine for the period 2018–2020 are presented. Reconstructive fundoplication according to Toupet was performed in one patient, and one patient underwent endoscopic dilatation of the esophagogastric junction using a Boston Scientific 3.0 balloon.

Conclusions. Pain reduction after a nasogastric tube placement and air venting from it is a tool to diagnose gas-bloat syndrome. Increasing aerogastria and stomach enlargement in 30–60 minutes after an additional meal make X-ray examination more informative and can be considered as new radiological symptoms. Toupet refundoplication is an effective surgical treatment for gas-bloat syndrome in patients after complete Nissen fundoplication.

Author Biographies

O. S. Tyvonchuk, SI “Shalimov’s National Institute of Surgery and Transplantation” of the National Academy of Medical Sciences of Ukraine, Kyiv

MD, PhD, DSc, Professor, Chief Researcher of the Department of Toracoabdominal Surgery

I. S. Tereshkevych, SI “Shalimov’s National Institute of Surgery and Transplantation” of the National Academy of Medical Sciences of Ukraine, Kyiv

MD, PhD, Senior Researcher of the Laboratory of Interventional Endoscopy

R. I. Vynohradov, SI “Shalimov’s National Institute of Surgery and Transplantation” of the National Academy of Medical Sciences of Ukraine, Kyiv

MD, Researcher of the Department of Toracoabdominal Surgery

D. Yu. Zhytnik, SI “Shalimov’s National Institute of Surgery and Transplantation” of the National Academy of Medical Sciences of Ukraine, Kyiv

MD, Surgical Resident of the Department of Toracoabdominal Surgery

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