Introducere: Hernia hiatala in 66% este asociata cu reflux gastro-esofagian. Tratamentu chirurgical al herniilor hiatale consta atit in lichidarea herniei
cu efectuarea crurorafiei, cit şi in efectuarea operatiei antireflux. Materiale si metode: Pe parcursul a doi ani in Clinica au fost tratați chirurgical 110
pacienți cu hernii hiatale și reflux gastro-esofagian. Diagnosticul s-a confirmat prin examinul clinic, radiologic, endoscopic și pH-metric. La 103
(93,6%) pacienți operația a fost efectuata laparoscopic, iar la 7 (6,4%) - prin laparotomie. În 107 (97,3%) cazuri a fost efectuata fundoplicația NissenRosetti, iar in trei (2,7%) - Dor. Ca metoda standard s-a utilizat crurorafia posterioara. Intr-un caz (0,9%) crurorafia nu a fost executata, iar la doi
(1,8%) pacienți crurorafia a fost atât posterioară, cât şi anterioară. Pacienții erau examinați clinic și radiologic inainte de externare, peste 30 şi 120 de
zile postoperator. Rezultate: În primele 30 zile postoperatoriu la 109 (99,1%) pacienți s-a notat dispariția semnelor patologice. La un pacient (0.9%) la
care s-a efectuat crurorafie posterioară şi fundoplicație Dor, peste o lună după operație a reapărut simptomatica existentă preoperator. La 86 (77,5%)
pacienți la examinarea radiologică efectuată în a 3-5 zi postoperator s-a constatat o dilatarea moderată a esofagului, dar fără dereglarea pasajului. Patru
pacienți (3,6%) au necesitat dilatare endoscopică. La doi (1,8%) bolnavi postoperator au apărut semne clinice si radiologice ale dereglarii evacuatoare
din stomac. Concluzii: Analiza rezultatelor precoce ale tratamentului chirurgical al herniilor hiatale și a refluxului gastro-esofagian în 99.1% cazuri
indică la dispariția semnelor existente preoperator. Disfagia postoperatorie este tranzitorii la mare majoritatea pacientilor.
Background: Hiatal hernia in 66% of cases is associated with gastro-esophageal reflux. Surgical treatment of hiatal hernia consists of removing the
hernia sac with cruroraphy and antireflux procedure. Materials and methods: During two years period in the Clinic were treated surgically 110 pts
with hiatal hernia and gastro- esophageal reflux. The diagnosis was confirmed by physical examination, X-ray, endoscopic and pH-metric studies.
In 103 (93,6%) pts the procedure was performed laparascopically, in 7 (6,4%) patients – by opened approach. The Nissen-Rosseti fundoplication has
been performed in 107 (97,3%) cases, and Dor - in 3 (2,7%). The posterior cruroraphy has been used as a standard method in all, exept of 3 (2,7%)
pts. Patients were examined clinically and radiologically (endoscopically) just upon discharging from the hospital, and 30 and 120 days after surgery.
Results: The complete disappearance of the pathological signs was noted in 109 pts (99,1%) within the first 30 days after surgery. In one (0,9%) patient,
which underwent posterior cruroraphy and Dor fundoplication, the initial symptomatology reappeared since one month after surgery. Radiological
study performed on the 3-5-th postoperative day noticed a moderated enlargement of the esophagus, but without evident passage disorders in 86 pts
(77,5%). Four (3,6%) pts required endoscopic dilatation of fundoplication zone. In 2 (1,8%) pts in the postoperative period were observed clinical and
radiological signs of delayed gastric empting. Conclusions: The early results analysis of surgical treatment for hiatal hernias and gastro-esophageal
reflux suggests disappearance of clinical symptomatology in 99,1% of pts. In mostly of patients the postoperative dysphagia is transitory.
