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Surgical Endoscopy
Published in: Surgical Endoscopy 1/2008

01-01-2008

Is a barium swallow complementary to endoscopy essential in the preoperative assessment of laparoscopic antireflux and hiatal hernia surgery?

Authors: Georg R. Linke, Jan Borovicka, Philipp Schneider, Andreas Zerz, Rene Warschkow, Jochen Lange, Beat P. Müller-Stich

Published in: Surgical Endoscopy | Issue 1/2008

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Abstract

Background

Barium swallow is considered essential in the preoperative assessment of gastroesophaeal reflux disease and hiatal hernias. The objective of this study was to investigate the effective value of a barium swallow if complementary to the commonly recommended endoscopy before laparoscopic antireflux and hiatal hernia surgery.

Methods

We prospectively evaluated 40 consecutive patients who were tested with preoperative barium swallow and endoscopy before laparoscopic surgery for gastroesophageal reflux disease and/or symptomatic hiatal hernia. Results regarding the presence and the type of hiatal hernia found by barium swallow and endoscopy were correlated with the intraoperative finding as the reference standard.

Results

Intraoperative findings revealed 21 axial, 7 paraesophageal, and 12 mixed hiatal hernias. Barium swallow and endoscopy allowed the diagnosis of hiatal hernia in 75% and 97.5%, respectively (p = 0.003). The correct classification of hiatal hernia was confirmed in 50% by barium swallow and 80% by endoscopy (p = 0.005).

Conclusions

Although barium swallow is recommended as an important diagnostic tool in the workup before surgical antireflux and hiatal hernia therapy, our results suggest that if mandatory endoscopy is performed preoperatively, a barium swallow does not provide any further essential information. It seems that barium swallow can be omitted as a basic diagnostic test before primary laparoscopic antireflux and hiatal hernia surgery.
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Metadata
Title
Is a barium swallow complementary to endoscopy essential in the preoperative assessment of laparoscopic antireflux and hiatal hernia surgery?
Authors
Georg R. Linke
Jan Borovicka
Philipp Schneider
Andreas Zerz
Rene Warschkow
Jochen Lange
Beat P. Müller-Stich
Publication date
01-01-2008
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 1/2008
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-007-9379-5

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