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06-12-2023 | Computed Tomography

High-resolution 3-dimensional tomography may be a useful tool for understanding the anatomy of hiatal hernias and surgical planning of patients eligible for laparoscopic or robotic antireflux surgery

Authors: André V. Santana, Fernando A. M. Herbella, Carlos E. Domene, Paula Volpe, William C. G. M. Neto, Rodrigo P. Polízio, Fernando D. Tamamoto, Rafael C. Katayama, Marco G. Patti

Published in: Surgical Endoscopy | Issue 2/2024

Abstract

Background

3D computed tomography (CT) has been seldom used for the evaluation of hiatal hernias (HH) in surgical patients. This study aims to describe the 3D CT findings in candidates for laparoscopic or robotic antireflux surgery or HH repair and compare them with other tests.

Methods

Thirty patients with HH and/or gastroesophageal reflux disease (GERD) who were candidates for surgical treatment and underwent high-resolution CT were recruited. The variables studied were distance from the esophagogastric junction (EGJ) to the hiatus; total gastric volume and herniated gastric volume, percentage of herniated volume in relation to the total gastric volume; diameters and area of the esophageal hiatus.

Results

HH was diagnosed with CT in 21 (70%) patients. There was no correlation between the distance EGJ-hiatus and the herniated gastric volume. There was a statistically significant correlation between the distance from the EGJ to the hiatus and the area of the esophageal hiatus of the diaphragm. There was correlation between tomographic and endoscopic findings for the presence and size of HH. HH was diagnosed with manometry in 9 (50%) patients. There was no correlation between tomographic and manometric findings for the diagnosis of HH and between hiatal area and lower esophageal sphincter basal pressure. There was no correlation between any parameter and DeMeester score.

Conclusions

The anatomy of HH and the hiatus can be well defined by 3D CT. The EGJ-hiatus distance may be equally measured by 3D CT or upper digestive endoscopy. DeMeester score did not correlate with any anatomical parameter.

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Title: High-resolution 3-dimensional tomography may be a useful tool for understanding the anatomy of hiatal hernias and surgical planning of patients eligible for laparoscopic or robotic antireflux surgery
Authors: André V. Santana
Fernando A. M. Herbella
Carlos E. Domene
Paula Volpe
William C. G. M. Neto
Rodrigo P. Polízio
Fernando D. Tamamoto
Rafael C. Katayama
Marco G. Patti
Publication date: 06-12-2023
Publisher: Springer US
Keywords: Computed Tomography
Computed Tomography
Endoscopy
Gastroesophageal Reflux Disease
Antireflux Surgery
Antireflux Surgery
Published in: Surgical Endoscopy / Issue 2/2024
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-023-10599-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

High-resolution 3-dimensional tomography may be a useful tool for understanding the anatomy of hiatal hernias and surgical planning of patients eligible for laparoscopic or robotic antireflux surgery

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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