nmpЖурнал им. Н.В. Склифосовского «Неотложная медицинская помощь»Russian Sklifosovsky Journal "Emergency Medical Care"2223-90222541-8017“N.V. Sklifosovsky Research Institute for Emergency Medicine”nmp-328Research ArticleКЛИНИЧЕСКИЕ НАБЛЮДЕНИЯCLINICAL OBSERVATIONSЛАПАРОСКОПИЧЕСКОЕ ЛЕЧЕНИЕ ГИГАНТСКОЙ ПАРАЭЗОФАГЕАЛЬНОЙ ГРЫЖИ С ИСПОЛЬЗОВАНИЕМ ДВУХСТОРОННЕЙ СЕТКИ С СИЛИКОНОВЫМ ПОКРЫТИЕМLAPAROSCOPIC MANAGEMENT OF GIANT PARAESOPHAGEAL HERNIA WITH A SILICONE-COATED BIFACIAL MESHУнгурянуС.UnguryanuS.ШипиткоН.ShipitkoN.

доцент кафедры Хирургии № 4

Associate Professor at the Department of Surgery no. 4

nsipitco@gmail.comГладунН.GladunN.ЛепадатуК.LepadatuC.Государственный университ медицины и фармации им. Николае ТестемицануМолдоваState Medical University of Medicine and Pharmacy n.a. nicolae TestemitanuMoldova, Republic of201625122016048791Copyright © Унгуряну С., Шипитко Н., Гладун Н., Лепадату К., 20162016Унгуряну С., Шипитко Н., Гладун Н., Лепадату К.Unguryanu S., Shipitko N., Gladun N., Lepadatu C.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.jnmp.ru/jour/article/view/328ВВЕДЕНИЕ

ВВЕДЕНИЕ. Параэзофагеальные грыжи встречаются относительно редко. В последнее время частота этого заболевания увеличилась, так что сегодня параэзофагеальные грыжи составляют 5–10% от всех хиатальных грыж. Всем пациентам с параэзофагеальными грыжами показано хирургическое лечение из-за возможных осложнений: ущемление, перфорация, кровотечение.

КЛИНИЧЕСКИЙ СЛУЧАЙ

КЛИНИЧЕСКИЙ СЛУЧАЙ. Пациент мужского пола, 44 года, с гигантской параэзофагеальной грыжей с характерной симптоматикой. Диагноз был подтвержден параклиническими и инструментальными методами исследования. Было выполнено лапароскопическое лечение хиатальной грыжи с использованием полипропиленовой сетки с силиконовым покрытием. Постоперационный период протекал без осложнений.

ЗАКЛЮЧЕНИЕ

ЗАКЛЮЧЕНИЕ. Лапароскопическая техника с успехом может быть использована при лечении параэзофагеальных грыж больших размеров. Опыт нашей клиники показал, что лечение подобных грыж лапароскопическим методом является надежным и безопасным при избирательном подходе к выбору больных. В случаях, когда размер хиатального отверстия больше 5 см, рекомендуется для его пластического закрытия использовать сетку, чтобы уменьшить частоту рецидивов грыжи.

BACKGROUND

BACKGROUND. Paraesophageal hernias are relatively uncommon. The incidence of this disease has increased recently, and esophageal hernias now account for 5–10% of all hiatus hernias. Surgical treatment is recommended for all patients with this disease because of high risk of complications: strangulation or perforation.

CASE REPORT

CASE REPORT. A 44-year-old male patient with a giant and symptomatic paraesophageal hernia. The diagnosis was confirmed by instrumental examination. We performed laparoscopic repair using silicone-coated polypropylene bifacial mesh. The postoperative period was uneventful.

CONCLUSION

CONCLUSION. The laparoscopic approach may be successfully used as a therapeutic option in the treatment for hiatal hernias. Our clinical experience showed, that the technique appeared to be valid and safe. In cases of large hiatal hernia with a defect greater than 5 cm, it is recommended to apply the mesh in order to minimize the recurrence rate.

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The authors declare that there are no conflicts of interest present.