METHOD OF CHOOSING THERAPEUTIC APPROACH IN RECURRENT HERNIAS OF OESOPHAGEAL OPENING OF DIAPHRAGM Russian patent published in 2020 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to abdominal surgery. To select a therapeutic approach in recurrent hernias of oesophageal opening of diaphragm, endoscopic, X-ray examination and pH-metrics of oesophagus are performed. According to the X-ray analysis with BaSO₄, the hernia type is evaluated, according to 24-hour impedance of oesophageal pH-meter - presence of gastroesophageal reflux. If observing the signs of paraesophageal or mixed hernia, spiral computed tomography of the thoracic and abdominal organs is additionally performed in order to detect a possible disruption of evacuation from the stomach and a therapeutic approach is selected depending on the anatomical type of the recurrent hernia. In the presence of axial and mixed hernias with gastroesophageal reflux or paraesophageal and mixed hernias with disturbed evacuation from the stomach, repeated surgical treatment is performed.

EFFECT: method enables improving a diagnostic algorithm for selecting a therapeutic approach, obtaining accurate confirmation of the need for surgical intervention in recurrent hernias of the oesophageal opening of the diaphragm, confirming anatomical changes leading to gastric evacuation disorders.

1 cl, 1 ex