ArticleJSLS : Journal of the Society of Laparoendoscopic Surgeons
A Reproducible Method of Measuring the Esophageal Hiatus and Potential Use in Hiatal Hernia Repairs.
Article in JSLS : Journal of the Society of Laparoendoscopic Surgeons. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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5 authors.
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Abstract
Objective: Esophageal hiatus closure during hiatal hernia repair is essential. Improper closure can lead to recurrence and high patient morbidity. Our aim is to introduce an easy and reproducible method of calculating the surface area (hiatal surface area [HSA]) of the esophageal hiatus. Standardization of this value will enable surgeons to have an evidence-based approach for hiatal hernia closure during laparoscopic repair. Methods and Procedures: We developed a measurement of HSA of the esophageal hiatus corresponding to a right-angle triangle: Area = (1/2) base × height. The height was defined as the left crus of the diaphragm. The base was defined as perpendicular to the crus and tangential to the medial edge of the esophagus. The mean esophageal hiatus surface area was calculated from deceased patients without a hiatal hernia undergoing full autopsies and compared to patients undergoing laparoscopic repair. Results: A total of 237 (37 cadaveric) hiatuses were measured. The median HSA defect in the cadaveric group was 1.97 cm Conclusion: This study demonstrated a new reproducible method of measurement for esophageal hiatus. The significant difference between the two groups suggests that our formula can be utilized to develop a standardized value for the surface area of the esophageal hiatus.
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