mossjМосковский хирургический журналMoscow Surgical Journal2072-3180ООО «ПРОФИЛЬ – 2С»10.17238/2072-3180-2022-4-114-123mossj-599Research ArticleОБЗОРЫREVIEWSПерспективы эндоскопического лечения пациентов с гетеротопией слизистой желудка в шейном отделе пищевода (обзор литературы)Perspectives of endoscopic treatment for patients with heterotopic gastric mucosa in the cervical esophagus (literature review)https://orcid.org/0000-0001-6444-4573ХихловаА. О.KhikhlovaA. O.

Хихлова Алина Олеговна – аспирант кафедры госпитальнойхирургии; врач-эндоскопист

454141, Челябинск, ул. Воровского, д. 70, стр. 5

Khikhlova Alina Olegovna – Postgraduate student at the Department of Hospital Surgery; Endoscopist of Endoscopy Department

70, bld. 5, Vorovskogo St., Chelyabinsk, 454141

alina_hihlova@mail.ruhttps://orcid.org/0000-0002-7385-8505ОлевскаяЕ. Р.OlevskayaE. R.

Олевская Елена Рафаиловна – доктор медицинских наук; заведующая отделением эндоскопии

454141, Челябинск, ул. Воровского, д. 70, стр. 5 

Olevskaya Elena Rafailovna – Doctor of Medical Sciences; Endoscopy Department Head

70, bld. 5, Vorovskogo St., Chelyabinsk, 454141

endo74@mail.ruhttps://orcid.org/0000-0003-2569-1699ДолгушинаА. И.DolgushinaA. I.

Долгушина Анастасия Ильинична – доктор медицинскихнаук, заведующая кафедрой госпитальной терапии

454141, Челябинск, ул. Воровского, д. 70, стр. 8

Dolgushina Anastasia Ilinichna – Doctor of Medical Sciences,Hospital Therapy Department Head

70, bld. 8, Vorovskogo St., Chelyabinsk, 454141

dolgushinaai@yandex.ruФГБОУ ВО «Южно-Уральский государственный медицинский университет» Минздрава РФ; ГБУЗ Челябинская областная клиническая больница, эндоскопическое отделениеРоссияDepartment of Hospital Surgery of South-Ural State Medical University; GBUZ Chelyabinsk Regional Clinical HospitalRussian FederationФГБОУ ВО «Южно-Уральский государственный медицинский университет» Минздрава РФРоссияSouth-Ural State Medical UniversityRussian Federation20220301202304114123Copyright © Хихлова А.О., Олевская Е.Р., Долгушина А.И., 20232023Хихлова А.О., Олевская Е.Р., Долгушина А.И.Khikhlova A.O., Olevskaya E.R., Dolgushina A.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.mossj.ru/jour/article/view/599

За последние годы отмечается интерес к проблеме гетеротопии слизистой желудка (СОЖ) в шейном отделе пищевода. Нерешенной проблемой является ведение пациентов с клиникой ларинго-фарингеального рефлюкса (ЛФР). Методы лечения данного состояния дискутабельны, четких алгоритмов не разработано. Большинство авторов сообщают о малой эффективности консервативной терапии. Радикальные хирургические методы носят исторический характер. Наибольшего внимания заслуживают эндоскопические методы лечения. Инвазивные эндоскопические вмешательства, такие как мукозальная резекция и диссекция в подслизистом слое, выполняют при развитии неоплазии в очагах желудочной гетеротопии в пищеводе. Применение аргоноплазменной коагуляции (АПК) и радиочастотной аблации (РЧА), направленных на эрадикацию очагов гетеротопии СОЖ в пищеводе с купированием клинической симптоматики, обеспечивает хорошие результаты. Учитывая локализацию гетеротопии и потенциальный риск развития послеоперационных стриктур пищевода, предпочтение стоит отдавать наиболее безопасной методике – РЧА. Многообразие малоинвазивных технологий при лечении симптомных пациентов с желудочной гетеротопией в пищеводе требует дальнейшего изучения для разработки стандартизованного подхода к выбору терапии.

In recent years, there has been growing interest in heterotopiс gastric mucosa (HGM) in the cervical esophagus. The management of patients with symptoms of laryngo-pharyngeal reflux (LPR) is unresolved issue. Methods of treatment are debatable, there are no clear strategies for HGM. Most authors report about low efficiency of conservative therapy. Radical surgical methods are historical in nature. Endoscopic methods of treatment deserve the greatest attention. The most invasive endoscopic approaches of treatment such as mucosal resection and submucosal dissection are used for neoplastic transformations of HGM in cervical esophagus. Argon plasma coagulation (APC) and radiofrequency ablation (RFA) provides good results aimed at eradicating of HGM in the esophagus and clinical symptoms. Pay attention to localization of heterotopia and potential risk of esophageal stricture formation, preference should be given to the safest technique RFA. The variety of minimally invasive technologies of treatment of symptomatic patients with HGM in the esophagus requires further research to develop standardized approach of therapy.

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The authors declare that there are no conflicts of interest present.