scholarly journals Surgical treatment of 125 cases with congenital diaphragmatic eventration in a single institution

2020 ◽  
Author(s):  
Shengliang Zhao ◽  
Zhengxia Pan ◽  
Yonggang Li ◽  
Yong An ◽  
Lu Zhao ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Open Surgery ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Operation Time ◽  
Diaphragmatic Eventration ◽  
Diaphragmatic Plication ◽  
Paradoxical Movement ◽  
First Choice ◽  
Surgical Methods

Abstract Backgrounds This study sought to investigate the clinical characteristics of congenital diaphragmatic eventration (CDE) and to compare the efficacy of thoracoscopy and traditional open surgery in infants with congenital diaphragmatic eventration. Methods We retrospectively analyzed the clinical data of 125 children with CDE(90 boys, 35girls; median age:12.2 months, range 1h-7years;body weight1.99-28.5kg,median body weight 7.87±4.40kg) admitted to our hospital in recent 10years,　and statistically analyzed their clinical manifestations and surgical methods. Results 108 children in this group underwent surgery, of which 67 underwent open surgery and 41 underwent thoracoscopic diaphragmatic plication.107 patients recovered well postoperatively, except for 1 patient died of respiratory distress after surgery.Followed up for 1-9.5 years,107 patients had significantly improved preoperative symptoms.During follow-up, the location of the diaphragm was normal and no paradoxical movement was observed.Eleven of the 17 children who did not undergo surgical treatment did not see a decrease in diaphragm position after 1-6 years of follow-up.In the thoracoscopy group, the index data on the operation time, intraoperative blood loss, chest drainage time, postoperative mechanical ventilation time, postoperative hospital stay and postoperative CCU admission time were better than those in the open group.The difference between the two groups was statistically significant (P＜0.05). Conclusions Clinical symptoms of congenital diaphragmatic eventration varied in severity. Patients with severe symptoms should be operated.Both thoracoscopic diaphragmatic plication and traditional open surgery can effectively treat congenital diaphragmatic eventration,but compared with open surgery, thoracoscopic diaphragmatic plication has the advantages of short operation time, less trauma, rapid recovery,　so it should be the first choice for children with congenital diaphragmatic eventration.

scholarly journals Surgical treatment of 125 cases of congenital diaphragmatic eventration in a single institution

BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Shengliang Zhao ◽  
Zhengxia Pan ◽  
Yonggang Li ◽  
Yong An ◽  
Lu Zhao ◽  
...  
Keyword(s):  
Body Weight ◽  
Surgical Treatment ◽  
Open Surgery ◽  
Clinical Manifestations ◽  
Operation Time ◽  
Diaphragmatic Eventration ◽  
Diaphragmatic Plication ◽  
First Choice ◽  
Surgical Methods

Abstract Background This study sought to investigate the clinical characteristics of congenital diaphragmatic eventration (CDE) and to compare the efficacies of thoracoscopy and traditional open surgery in infants with CDE. Methods We retrospectively analyzed the clinical data of 125 children with CDE (90 boys, 35 girls; median age: 12.2 months, range: 1 h-7 years; body weight: 1.99–28.5 kg, median body weight: 7.87 ± 4.40 kg) admitted to our hospital in the previous 10 years, and we statistically analyzed their clinical manifestations and surgical methods. Results A total of 108 children in this group underwent surgery, of whom 67 underwent open surgery and 41 underwent thoracoscopic diaphragmatic plication. A total of 107 patients recovered well postoperatively, except for 1 patient who died due to respiratory distress after surgery. After 1–9.5 years of follow-up, 107 patients had significantly improved preoperative symptoms. During follow-up, the location of the diaphragm was normal, and no paradoxical movement was observed. Eleven of the 17 children who did not undergo surgical treatment did not have a decrease in diaphragm position after 1–6 years of follow-up. The index data on the operation time, intraoperative blood loss, chest drainage time, postoperative mechanical ventilation time, postoperative hospital stay and postoperative CCU admission time were better in the thoracoscopy group than in the open group. The difference between the two groups was statistically significant (P < 0.05). Conclusions The clinical symptoms of congenital diaphragmatic eventration vary in severity. Patients with severe symptoms should undergo surgery. Both thoracoscopic diaphragmatic plication and traditional open surgery can effectively treat congenital diaphragmatic eventration, but compared with open surgery, thoracoscopic diaphragmatic plication has the advantages of a short operation time, less trauma, and a rapid recovery. Thus, thoracoscopic diaphragmatic plication should be the first choice for children with congenital diaphragmatic eventration.

scholarly journals Surgical treatment of 125 cases of congenital diaphragmatic eventration in a single institution

2020 ◽  
Author(s):  
Shengliang Zhao ◽  
Zhengxia Pan ◽  
Yonggang Li ◽  
Yong An ◽  
Lu Zhao ◽  
...  
Keyword(s):  
Body Weight ◽  
Surgical Treatment ◽  
Open Surgery ◽  
Clinical Manifestations ◽  
Operation Time ◽  
Diaphragmatic Eventration ◽  
Diaphragmatic Plication ◽  
First Choice ◽  
Surgical Methods

Abstract Background: This study sought to investigate the clinical characteristics of congenital diaphragmatic eventration (CDE) and to compare the efficacies of thoracoscopy and traditional open surgery in infants with CDE.Methods: We retrospectively analyzed the clinical data of 125 children with CDE (90 boys, 35 girls; median age: 12.2 months, range: 1 h-7 years; body weight: 1.99-28.5 kg, median body weight: 7.87±4.40 kg) admitted to our hospital in the previous 10 years,　and we statistically analyzed their clinical manifestations and surgical methods.Results: A total of 108 children in this group underwent surgery, of whom 67 underwent open surgery and 41 underwent thoracoscopic diaphragmatic plication. A total of 107 patients recovered well postoperatively, except for 1 patient who died due to respiratory distress after surgery. After 1-9.5 years of follow-up, 107 patients had significantly improved preoperative symptoms. During follow-up, the location of the diaphragm was normal, and no paradoxical movement was observed. Eleven of the 17 children who did not undergo surgical treatment did not have a decrease in diaphragm position after 1-6 years of follow-up. The index data on the operation time, intraoperative blood loss, chest drainage time, postoperative mechanical ventilation time, postoperative hospital stay and postoperative CCU admission time were better in the thoracoscopy group than in the open group. The difference between the two groups was statistically significant (P<0.05).Conclusions: The clinical symptoms of congenital diaphragmatic eventration vary in severity. Patients with severe symptoms should undergo surgery. Both thoracoscopic diaphragmatic plication and traditional open surgery can effectively treat congenital diaphragmatic eventration, but compared with open surgery, thoracoscopic diaphragmatic plication has the advantages of a short operation time, less trauma, and a rapid recovery.　Thus, thoracoscopic diaphragmatic plication should be the first choice for children with congenital diaphragmatic eventration.

scholarly journals Surgical treatment of 125 cases of congenital diaphragmatic eventration in a single institution

2020 ◽  
Author(s):  
Shengliang Zhao ◽  
Zhengxia Pan ◽  
Yonggang Li ◽  
Yong An ◽  
Lu Zhao ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Open Surgery ◽  
Clinical Characteristics ◽  
Clinical Symptoms ◽  
Operation Time ◽  
Diaphragmatic Eventration ◽  
Diaphragmatic Plication ◽  
Paradoxical Movement ◽  
First Choice

Abstract Backgrounds: This study sought to investigate the clinical characteristics of congenital diaphragmatic eventration (CDE) and to compare the efficacies of thoracoscopy and traditional open surgery in infants with CDE. Methods: This study sought to investigate the clinical characteristics of congenital diaphragmatic eventration (CDE) and to compare the efficacies of thoracoscopy and traditional open surgery in infants with CDE. Results: A total of 108 children in this group underwent surgery, of whom 67 underwent open surgery and 41 underwent thoracoscopic diaphragmatic plication. A total of 107 patients recovered well postoperatively, except for 1 patient who died due to respiratory distress after surgery. After 1-9.5 years of follow-up, 107 patients had significantly improved preoperative symptoms. During follow-up, the location of the diaphragm was normal, and no paradoxical movement was observed. Eleven of the 17 children who did not undergo surgical treatment did not have a decrease in diaphragm position after 1-6 years of follow-up. The index data on the operation time, intraoperative blood loss, chest drainage time, postoperative mechanical ventilation time, postoperative hospital stay and postoperative CCU admission time were better in the thoracoscopy group than in the open group. The difference between the two groups was statistically significant (P<0.05). Conclusions: The clinical symptoms of congenital diaphragmatic eventration vary in severity. Patients with severe symptoms should undergo surgery. Both thoracoscopic diaphragmatic plication and traditional open surgery can effectively treat congenital diaphragmatic eventration, but compared with open surgery, thoracoscopic diaphragmatic plication has the advantages of a short operation time, less trauma, and a rapid recovery.　Thus, thoracoscopic diaphragmatic plication should be the first choice for children with congenital diaphragmatic eventration.

scholarly journals Surgical treatment of 125 cases with congenital diaphragmatic eventration in a single institution

2020 ◽  
Author(s):  
Shengliang Zhao ◽  
Zhengxia Pan ◽  
Yonggang Li ◽  
Yong An ◽  
Lu Zhao ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Open Surgery ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Operation Time ◽  
Treatment Method ◽  
Diaphragmatic Eventration ◽  
Time To Peak ◽  
Surgical Methods ◽  
Better Than

Abstract Background:This study sought to investigate the clinical characteristics of congenital diaphragmatic eventration (CDE) and to compare the efficacy of thoracoscopy and traditional open surgery in infants with congenital diaphragmatic eventration.Methods: We retrospectively analyzed the clinical data of 125 children with CDE(90 boys, 35girls; median age:12.2 months, range 1h-7years;body mass1.99-28.5kg,median body mass 7.87±4.40kg) admitted to our hospital in recent 10years,and statistically analyzed their clinical manifestations and surgical methods. Results:108 children in this group underwent surgery, of which 67 underwent open surgery and 41 underwent thoracoscopic diaphragmatic Plication.107 patients recovered well postoperatively, except for 1 patient with hiatal hernia died of respiratory distress after surgery.Followed up for 1-9.5 years,107 patients had significantly improved preoperative symptoms.Eleven of the 17 children who did not undergo surgical treatment did not see a significant decrease in diaphragm position after 1-6 years of follow-up.In the thoracoscopy group, the lung function values of 13 children before operation and 3 year after operation was compared. The difference in percent of expiratory time to peak tidal time (tPTEF%tE) and percentage of tidal volume to peak tidal expiratory flow(VPEF%VE) was significant (P<0.05).In the thoracoscopy group, the index data on the operation time, intraoperative blood loss, chest drainage time, postoperative mechanical ventilation time, postoperative hospital stay and postoperative CCU admission time were better than those in the open group.The difference between the two groups was statistically significant (P＜0.05). Conclusions: Clinical symptoms of congenital diaphragmatic eventration varied in severity. Patients with severe symptoms should be operated early. All kinds of surgical methods can achieve better results.The clinical symptoms of children after diaphragm Plication operation are better than those before operation.We believe that the continuous suture of barbed wire thread applied to thoracoscopy diaphragm Plication surgery has quick operation time, less trauma, and quick recovery should be the preferred treatment method for infants with congenital diaphragmatic eventration.

scholarly journals SURGICAL TREATMENT OF ANOMALIES OF FIXATION OF THE COLON IN CHILDREN

2020 ◽  
Vol 19 (4) ◽  
pp. 32-36
Author(s):  
O. Bodnar
Keyword(s):  
Congenital Anomaly ◽  
Surgical Treatment ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Results Of Treatment ◽  
Left Diaphragm ◽  
Comparative Group ◽  
The Right ◽  
Paroxysmal Pain ◽  
Over Time

Pyrrhic disease is a congenital anomaly that occurs during embryogenesis due to the fixation of the splenic angle of the colon by a short and highly located left transverse-diaphragmatic ligament, creating a sharp bend and forming a "wellbore". In this case the passage of feces on a cross colon becomes difficult, there is also its sagging to a small pelvis. This pathology is characterized by paroxysmal pain (aggravated by exercise and after eating) and prolonged constipation, which progresses over time. Hilaiditis syndrome is a rather rare pathology in which there is an interposition of the hepatic angle of the colon between the liver and the diaphragm. There are permanent and intermittent localizations. The work generalizes the experience of evaluation of clinical manifestations and remote results of treatment of children with chronic colostasis caused by fixation abnormalities of the colon. 58 children were detected to have Payre’s disease, with Cyilaiditi’s syndrome – 3 children. 24 patients with Payre’s disease and 2 Cyilaiditi’s syndrome were operated on. To assess the effectiveness of surgery, children were divided into two groups: I group – comparative and II group - experienced. In I group (n=12 children) – the analysis of surgical treatment was performed traditionally. In II group (n=14 children) – the analysis of surgical treatment was conducted by means of the methods proposed. Traditional surgical treatment of Payre’s disease in children was followed by relapse of chronic constipation in 45,45%, pain in 50%, flatulence in 33,33% and failure of the ileocoecal closing apparatus in 100% of children. Unsatisfactory outcomes of surgical treatment of Cyilaiditi’s syndrome was observed in a child from the comparative group. Relapse of clinical symptoms to a lesser degree than before the surgery was found in 1 child from the experienced group. To treat Payre’s disease the following operation is proposed: intersection of the left diaphragm-colon ligament, resection of transverse colon and colofixation of the left bending of the colon. To treat Cyilaiditi’s syndrome (in case of dolichoascendocolon) the following operation is suggested: hepatopexy, resection of the right bending of the colon with ascending transversal anastomosis “end to end”, fixing of right bending of the colon. Their reasonability is being proved.

scholarly journals CONSERVATIVE TREATMENT OF HEMORRHOIDS. AN ALTERNATIVE TO SURGICAL METHODS OR COMPONENTS? CHORUS PROGRAM RESULTS

2018 ◽  
pp. 27-35
Author(s):  
E. A. Zagryadskiy ◽  
A. M. Bogomazov ◽  
E. B. Golovko
Keyword(s):  
Surgical Treatment ◽  
Conservative Treatment ◽  
Clinical Manifestations ◽  
Entire Observation Period ◽  
Surgical Methods ◽  
Micronized Purified Flavonoid Fraction ◽  
Flavonoid Fraction ◽  
Observational Group ◽  
Grade Iii ◽  
Observation Period

OBJECTIVE. Determine the frequency of clinical manifestations of hemorrhoids and constipation in people seeking advice about hemorrhoids. In the course of the treatment of patients with hemorrhoids phlebotropic evaluate the effectiveness of therapy micronized purified flavonoid fraction (MPFF). MATERIALS AND METHODS. This multicenter study, including screening and observation part, which is part of the International Research «CHORUS» (Chronic venous and hemorrhoid diseases evaluation and scientific research), conducted in nine centers in different regions of Russia, 80 doctors of Coloproctology. In the screening group included 2668 patients who had investigated the incidence of constipation, as a risk factor for hemorrhoids. Conservative treatment, the foundation of which was, Moffitt therapy, received 1952 patients with stage I-IV hemorrhoids. Evaluating the effectiveness of the treatment was evaluated on the basis of a questionnaire. RESULTS. The questionnaire shows that constipation suffered - 766 (28,8 %) patients. Violation of defecation patterns and changes in stool consistency was observed in 1155 (43,9%) and 633 (25.5 %), respectively. At the same time, 288 (11,1 %) indicated a tendency to loose stools and diarrhea. Conservative treatment, the foundation of which is phlebotropic MPFF therapy conducted in patients of observational group has shown its efficiency in all grades of hemorrhoids. During the entire observation period of conservative treatment was effective in 1489 (76,3 %) patients. Surgical treatment was performed in 463 (23 %) patients grade I-IV hemorrhoids, the main part of patients with grade III -199 (43,1 %) and grade IV hemorrhoids - 68 (64,2 %). CONCLUSION. Conservative treatment of hemorrhoid disease, which is the basis on phlebotropic MPFF therapy, is effective at all stages of hemorrhoids, but in patients with grade III and grade IV disease requires surgical treatment.

Emergency ESWL in ureteral lithiasis

1997 ◽  
Vol 64 (1) ◽  
pp. 22-25
Author(s):  
E. Frego ◽  
M. Scanzi ◽  
A. Botturi ◽  
S. Cosciani Cunico
Keyword(s):  
Open Surgery ◽  
Shock Wave Lithotripsy ◽  
Clinical Symptoms ◽  
Ureteral Stones ◽  
X Rays ◽  
X Ray ◽  
Non Invasive ◽  
Extracorporeal Shock Wave ◽  
First Choice ◽  
Ureteral Lithiasis

Extracorporeal shock wave lithotripsy (ESWL) may be considered first-choice treatment for upper ureteral stones; for lower ureteral stones, an endoscopie approach gives a high success rate but also higher morbidity. Over a period of 18 months in our Department, 275 consecutive patients with ureteral stones underwent ESWL. In 40 patients (14.5%) ESWL was performed within 48 hours of onset of acute renai colie; stone diameters were 7.5 mm average (range 5-20 mm). Ten patients (25%) were treated after ultrasonography and abdomen X-rays, while 30 patients also underwent an I.V.P. Shock waves required for fragmentation were 1503 on average (range 437-2650). All patients were treated after sedation-analgesia. All patients had remission of clinical symptoms after ESWL and one month later were all stone-free at X-ray and ultrasonographic control. Just one complication was observed: a small perineal hematoma that required no treatment. On the basis of our data, emergency ESWL is suggested as a non-invasive, easy-to-perform, well-tolerated treatment giving immediate remission of clinical symptoms. When unsuccessful, it does not preclude endoscopy or open surgery. Emergency ESWL has proved to be the treatment of choice due to the high percentage of total stone elimination, lack of anesthesia, few complications and excellent patient compliance.

scholarly journals Consensus statement on diagnosis and treatment of cervical ossification of posterior longitudinal ligament from Asia Pacific Spine Society (APSS) 2020

2020 ◽  
Vol 28 (3) ◽  
pp. 230949902097521
Author(s):  
Xiao-fei Sun ◽  
Yuan Wang ◽  
Jing-chuan Sun ◽  
Xi-ming Xu ◽  
Qing-jie Kong ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Consensus Statement ◽  
Clinical Symptoms ◽  
Posterior Longitudinal Ligament ◽  
Diagnosis And Treatment ◽  
Asia Pacific ◽  
Ct Reconstruction ◽  
Whole Process ◽  
Surgical Methods ◽  
Level Of Agreement

Purpose: The study aimed to develop an evidence-based expert consensus statement on diagnosis and treatment of cervical ossification posterior longitudinal ligament (OPLL). Method: Delphi method was used to perform such survey, and the panel members from Asia Pacific Spine Society (APSS) 2020 were invited to answer the open-ended questions in rounds 1 and 2. Then the results were summarized and developed into a Likert-style questionnaire for voting in round 3, and the level of agreement was defined as 80%. In the whole process, we conducted a systematic literature search on evidence for each statement. Results: Cervical OPLL can cause various degrees of neurological symptoms, an it’s thought to be more common in Asia population. CT reconstruction is an important imaging examination to assist diagnosis and guide surgical choice. Segmental, continuous, mixed, and focal type is the most widely used classification system. The non-surgical treatment is recommended for patients with no or mild clinical symptoms, or irreversible neurological damage, or failed surgical decompression, or condition cannot tolerant surgery, or refusing surgery. As OPLL may continue to develop gradually, surgical treatment would be considered in their course inevitably. The surgical choice should depend on various conditions, such as involved levels, thickness, and type of OPLL, skill-experiences of surgeons, which are listed and discussed in the article. Conclusion: In this statement, we describe the clinical features, classifications, and diagnostic criteria of cervical OPLL, and review various surgical methods (such as their indications, complications), and provide a guideline on their choice strategy.

scholarly journals A comparative study on the Efficacy of Retroperitoneoscopic Pyeloplasty and Open Surgery for Ureteropelvic Junction Obstruction in Children

2021 ◽  
Vol 37 (7) ◽  
Author(s):  
Jianghua Jia ◽  
Qingsong Meng ◽  
Ming Zhang ◽  
Jinchun Qi ◽  
Dongbin Wang
Keyword(s):  
Comparative Study ◽  
Open Surgery ◽  
Ureteropelvic Junction Obstruction ◽  
Operation Time ◽  
Ureteropelvic Junction ◽  
Intraoperative Bleeding ◽  
Conversion To Open Surgery ◽  
Bleeding Volume ◽  
Surgical Methods ◽  
Significant Difference

Objectives: To compare the therapeutic effect of retroperitoneoscopic dismembered pyeloplasty and open ureteropelvic junction plasty on the ureteropelvic junction obstruction (UPJO) in children. Methods: After the retrospective analysis of clinical data, 78 children with ureteropelvic junction stenosis treated from January, 2012 to June, 2018 were divided into two groups: OP (open pyeloplasty) group (38 cases) and LP (laparoscopic dismembered pyeloplasty) group (40 cases) according to the surgical methods. The operation time, intraoperative bleeding volume, postoperative length of stay (LOS), postoperative complication rate, postoperative hydronephrosis improvement and other indicators were compared between the two groups. Results: All patients underwent surgery successfully, without conversion to open surgery in LP group. The incidence of postoperative urine leakage and the recovery of hydronephrosis between LP group and OP group 12 months after operation showed no statistically significant difference (P>0.05). The intraoperative bleeding volume, the incidence of postoperative retroperitoneal hematoma, and the postoperative LOS in LP group were lower than those in OP group, while the operation time was longer than that in the OP group, with statistically significant difference (P<0.05). Conclusion: Retroperitoneoscopic dismembered pyeloplasty had similar effect with open dismembered pyeloplasty, but faster recovery and fewer complications, so it has become the preferred treatment method for UPJO in children. doi: https://doi.org/10.12669/pjms.37.7.4205 How to cite this:Jia J, Meng Q, Zhang M, Qi J, Wang D. A comparative study on the Efficacy of Retroperitoneoscopic Pyeloplasty and Open Surgery for Ureteropelvic Junction Obstruction in Children. Pak J Med Sci. 2021;37(7):---------.  doi: https://doi.org/10.12669/pjms.37.7.4205 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals LONG-TERM RESULTS AFTER VIDEO ENDOSCOPIC MYOTOMY BY HELLER WITH FUNDOPLICATION BY DOR IN PATIENTS WITH 2-4 STAGES OF ACHALASIA

2021 ◽  
pp. 40-49
Author(s):  
V. A. Gankov ◽  
E. A. Tseimakh ◽  
G. I. Bagdasaryan ◽  
A. R. Andreasyan ◽  
S. A. Maslikova
Keyword(s):  
Surgical Treatment ◽  
Postoperative Period ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Long Term Results ◽  
Esophageal Function ◽  
X Ray ◽  
Leading Symptom ◽  
Instrumental Methods

Relevance. Treatment of achalasia of the cardia (AС) is currently palliative, aimed at reducing the manifestation of clinical symptoms of the disease. Together with instrumental methods of examination of esophageal function, the Eckardt scale and the GIGLI questionnaire are convenient and simple tools for evaluating results in the long-term postoperative period.The aim of the study was to evaluate the long-term results of surgical treatment of patients with 2-4 stages of AС, after laparoscopic Нeller myotomy with anterior hemiesophagofundoplication by Dor to the results of special methods of esophageal examination and patient questionnaires using the Eckardt scale and the GIGLI questionnaire.Materials and methods. The work included the results of examinations of 103 patients who underwent video laparoscopic Нeller myotomy, with anterior hemiesophagofundoplication by Dor. The period of examination in the postoperative period was from 3 to 7 years. The results of X-ray examination of the esophagus and stomach, manometry of the esophageal and esophageal-gastric junction before and after surgery were studied , and patients were also surveyed according to the Eckardt scale and the GIGLI questionnaire.Results. The analysis of the results of instrumental methods of studying the function of the esophagus in the pre – and postoperative periods showed that the given manometry of the esophagus and esophageal-gastric junction, X-ray of the esophagus and stomach significantly improved in the postoperative period in patients with all stages of the disease. The results of patients of 4th stage AC compared with the results of 2nd and 3rd stages patients were worse(p<0,05).The leading symptom of AK-dysphagia in the long-term postoperative period decreased in all the studied patients, the results were better in patients with stage 2, worse in patients with stage 4 of AK (p<0,05).The leading symptom of AK-dysphagia in the long-term postoperative period decreased in all the studied patients, the 2nd stage patients results were better, 4th stage patients results were worse (p<0,05).Conclusions. After video-endoscopic Нeller myotomy with fundoplication by Dor, the indicators of esophageal manometry and esophageal and stomach radiography significantly improve, the results of the Eckardt scale and GIGLI questionnaire survey of patients show a significant decrease in the severity of clinical manifestations of AC in the balls. This method of surgical treatment can be recommended already at the 2nd stage of AC and as an organpreserving operation for 4th stage.

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