The British journal of surgery · 1997
Oesophageal and cardia function in patients with paraoesophageal hiatus hernia.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Zaninotto G, Costantini M, Anselmino M, Boccù C, Molena D, Rigotti P, Merigliano S, Ancona E
Аннотация
BACKGROUND: The decision to add an antireflux procedure when a paraoesophageal hernia is repaired is still controversial. The aim of this study was to investigate oesophageal and cardia function in these patients to verify whether fundoplication was needed.
METHODS: Eighteen patients with paraoesophageal hernia were evaluated by oesophageal manometry, 24-h pH monitoring, endoscopy and barium swallow. All patients underwent surgery including antireflux fundoplication. Fourteen patients with sliding hernia plus reflux disease and 16 healthy volunteers formed the control groups.
RESULTS: Patients with paraoesophageal hernia had a shorter lower oesophageal sphincter and a greater acid exposure than healthy controls (P < 0.05). Fifteen of 18 patients had either abnormal acid exposure and/or a defective lower oesophageal sphincter at manometry. Postfundoplication symptoms were observed in only one of 16 patients at 6 months' follow-up.
CONCLUSION: Since 15 of 18 patients had abnormal acid exposure or were considered prone to developing gastro-oesophageal reflux disease because of a defective lower oesophageal sphincter, this study strongly supports the need to add an antireflux operation to hernia repair.
METHODS: Eighteen patients with paraoesophageal hernia were evaluated by oesophageal manometry, 24-h pH monitoring, endoscopy and barium swallow. All patients underwent surgery including antireflux fundoplication. Fourteen patients with sliding hernia plus reflux disease and 16 healthy volunteers formed the control groups.
RESULTS: Patients with paraoesophageal hernia had a shorter lower oesophageal sphincter and a greater acid exposure than healthy controls (P < 0.05). Fifteen of 18 patients had either abnormal acid exposure and/or a defective lower oesophageal sphincter at manometry. Postfundoplication symptoms were observed in only one of 16 patients at 6 months' follow-up.
CONCLUSION: Since 15 of 18 patients had abnormal acid exposure or were considered prone to developing gastro-oesophageal reflux disease because of a defective lower oesophageal sphincter, this study strongly supports the need to add an antireflux operation to hernia repair.