PATHOGENETIC SUBSTANTIATION OF NEW SURGICAL TREATMENT
OF GASTROESOPHAGEAL REFLUX DISEASE AND HIATAL HERNIA 

Baulin Vladimir Anatol'evich, Candidate of medical sciences, assistant, sub-department of surgery and endoscopy, Penza Institute of Advanced Medical Studies of the Russian Ministry of Health
(8a Stasova street, Penza, Russia), voviku1984@mail.ru
Baulina Ol'ga Aleksandrovna, Postgraduate student, Penza Institute of Advanced Medical Studies of the Russian Ministry of Health (8a Stasova street, Penza, Russia), olga.kosenko@mail.ru
Sigaeva Nadezhda Sergeevna, Postgraduate student, Penza Institute of Advanced Medical Studies of the Russian Ministry of Health (8a Stasova street, Penza, Russia), loto4ek@mail.ru
Baulina Ekaterina Anatol'evna, Candidate of medical studies, assistant, sub-department of hospital surgery, First Moscow State Medical University named after I.M. Sechenov of the Russian Ministry of Health
(side 2, 8 Trubetskaya street, Moscow, Russia), xirurg58@gmail.com
Akzhigitova Anastasiya Aleksandrovna, Postgraduate student, Penza Institute of Advanced Medical Studies of the Russian Ministry of Health (8a Stasova street, Penza, Russia), sl.slastena2012@yandex.ru

617-089.844

Background. The article aims at revising the concept of pathogenesis of the gastroesophageal reflux disease, creating an effective and reasonable method of pathogenetic surgical treatment of the gastroesophageal reflux disease and hiatal hernia.
Materials and methods. For detailed evaluation of pathogenesis of the gastroe-sophageal reflux disease the authors studied more than 300 foreign and local sources of literature. As a primary diagnostic method the researchers used videoesophagogastroduodenoscopy and roentgenoscopy of the esophagus, stomach and duodenum. 126 patients were operated by the developed method with the use of polypropylene mesh.
Results. Pathogenesis of the gastroesophageal reflux disease is based on disad-vantageous phylogenetic reconstruction of anatomical structures: diaphragm legs, ligaments, esophagus and stomach. The authors developed an endoscopic 4-stage classification of cardia failure. Clinical data on the patients operated by the new method in 87,5 % were regarded as excellent and good, endoscopic assessment conducted by the same endoscopist showed excellent and good results in 93 % of patients.
Conclusions. First positive results show that the suggested classification used for cardia failure as an objective endoscopic evidence of changes in the esophageal-gastric junction has a right to exist, and the developed and pathogenetically based method of surgical treatment of patients with the gastroesophageal reflux disease and hiatal hernia is quite effective.

gastroesophageal reflux desease, hiatal hernia, cardia insufficiency, antireflux surgery.

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