SHORT ESOPHAGUS AS A SURGICAL PROBLEM IN PATIENTS WITH GASTROESOPHAGEAL HERNIAS

Purpose of the study. To analyze the clinical case of a patient with hiatal hernia in a short esophagus and to show the importance of preoperative esophageal length assessment in deciding surgical tactics and possible intraoperative risks and postoperative complications.

Material and methods. An analysis of the results of diagnostics and surgical treatment of a patient who was being treated in the surgical department of the 5th city clinical hospital in Minsk in 2025 and in 2026 was carried out.

Results and discussion. When performing laparoscopic interventions in patients with hiatus hernias with grade I esophageal shortening, it was almost always possible to lower the abdominal segment of the esophagus into the abdominal cavity. In case when grade II esophageal shortening took place, some technical difficulties occurred in the operation. When the esophagus being brought down into the abdominal cavity in the operation and the posterior cruroraphy, the position of the distal part of the esophagus could be changed with a length of 5–6 cm and the left dome of the diaphragm could be shifted upward, which can cause impaired functions of the cardiovascular and respiratory systems in the postoperative period.

Conclusion. A timely diagnosis of a short esophagus and adequate surgical treatment are the key to success in performing anti-reflux operations. When performing laparoscopic operations in patients with a short esophagus, the degree of shortening of the esophagus, the presence of inflammatory and sclerotic changes in the esophagus and paraesophageal zone, and the condition of nearby chest organs should be taken into account.

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