Intraoperative Measurement of Esophageal Hiatus Normal Area Size in Patients without Hiatus Hernia or Gastroesophageal Reflux Disease
Amir K Abosayed, Mohamed Saber Mostafa, Ahmed Maher Hassan, Ahmed Yahia Abdel Dayem
Esophageal hiatus, Intraoperative, Normal size
Citation Information :
Abosayed AK, Mostafa MS, Hassan AM, Dayem AY. Intraoperative Measurement of Esophageal Hiatus Normal Area Size in Patients without Hiatus Hernia or Gastroesophageal Reflux Disease. World J Lap Surg 2022; 15 (2):95-98.
Background: Untreated gastroesophageal reflux disease (GERD) and the associated reflux esophagitis have been negatively impacting the quality of life to a great extent. Data about the normal size of the hiatus opening seems to be prophylactic against the possible anti-reflux surgery postoperative wrap herniation into the thorax that occurs as a result of inadequate crural closure or its disrupted closure. This study aimed at determination of normal size of esophageal hiatus in adults, in an attempt to improve the outcome of anti-reflux surgeries.
Patients and methods: This is a prospective study that was conducted on adult patients consecutively scheduled for abdominal surgery, either open or laparoscopic. Intraoperatively, a calibrated 36-French bougie with a balloon was introduced to the stomach through the mouth. The diameter of the balloon was measured when it was insufflated with the maximum volume that could pass through the hiatus.
Results: Esophageal hiatus area ranged from 2 cm to 6.6 cm2 with a mean value of 3.8 cm2. No significant difference was found between males and females in the measured parameters (p >0.05). No significant correlation was found between the hiatus surface area and the patient's age, height, weight, BMI, chest circumference, or the esophageal parameters (p >0.05).
Conclusion: This study reported a new mean value of the normal hiatus surface area in order to give a hand in improving the anti-reflux surgery outcome. Further studies on a large cohort are needed to estimate normal variations in regard to age and sex to help in improvement of anti-reflux surgery outcome.
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