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Erschienen in: Journal of Gastrointestinal Surgery 1/2010

01.01.2010 | Original Article

The Size of the Esophageal Hiatus in Gastroesophageal Reflux Pathophysiology: Outcome of Intraoperative Measurements

verfasst von: Hasan Fevzi Batirel, Oya Uygur-Bayramicli, Adnan Giral, Bülent Ekici, Nural Bekiroglu, Bedrettin Yildizeli, Mustafa Yüksel

Erschienen in: Journal of Gastrointestinal Surgery | Ausgabe 1/2010

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Abstract

Objective

The aim of the study was to investigate the impact of the size of the esophageal hiatus on lower esophageal sphincter pressure (LESP) and acid reflux.

Methods

Patients with gastroesophageal reflux disease who underwent Nissen fundoplication in 2006–2008 were included. All underwent esophageal manometry and 22 had 24-h pH monitoring. The area of the esophageal hiatus was calculated from a photograph shot during surgery. A hiatal index was calculated via division of hiatal area with body mass index (BMI). Correlation and logistic regression analysis were performed.

Results

Twenty-eight patients (average age 44, 14 males) were enrolled. The mean BMI, LESP, DeMeester score, hiatal area, and hiatal index were 27 ± 3.9 kg/m2, 11.7 ± 6.6 mmHg, 43 ± 34, 3.83 ± 1.24 cm2, and 0.143 ± 0.048, respectively. There was a significant negative correlation between hiatal area, hiatal index and LESP (−0.513, p = 0.005, r = −0.439, p = 0.019 respectively). Additionally there was a negative correlation between hiatal area and total LES length (r = −0.508, p = 0.013) and a significant positive correlation between hiatal area, hiatal index, and DeMeester scores (0.452, p = 0.035, 0.537, p = 0.01, respectively). Height and hiatal area were significant factors in multiple linear regression.

Conclusions

The size of the esophageal hiatus significantly affects LESP and acid reflux, and hiatal index is a new value, which appears to reflect the amount of acid reflux. Total LES length is also shortened in patients with a large hiatus.
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Metadaten
Titel
The Size of the Esophageal Hiatus in Gastroesophageal Reflux Pathophysiology: Outcome of Intraoperative Measurements
verfasst von
Hasan Fevzi Batirel
Oya Uygur-Bayramicli
Adnan Giral
Bülent Ekici
Nural Bekiroglu
Bedrettin Yildizeli
Mustafa Yüksel
Publikationsdatum
01.01.2010
Verlag
Springer-Verlag
Erschienen in
Journal of Gastrointestinal Surgery / Ausgabe 1/2010
Print ISSN: 1091-255X
Elektronische ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-009-1047-8

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