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Surgical Endoscopy
Published in: Surgical Endoscopy 5/2009

01-05-2009

Clinical relevance of laparoscopically diagnosed hiatal hernia

Authors: Yves Van Nieuwenhove, Jeroen Sonck, Boudewijn De Waele, Peter Potvlieghe, Georges Delvaux, Patrick Haentjens

Published in: Surgical Endoscopy | Issue 5/2009

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Abstract

Background

To determine the clinical relevance of a laparoscopically diagnosed hiatal hernia.

Methods

Consecutive patients undergoing an elective laparoscopy were prospectively recruited. We assessed preoperative gastroesophageal reflux symptoms using a validated score, and documented the presence or absence of a hiatal hernia during laparoscopy.

Results

Of the 95 evaluable patients, 42 (44%) had a hiatal hernia. The mean age was 49.8 years. Logistic regression analysis indicated that three features were significantly and independently associated with hiatal hernia: a higher reflux score (odds ratio [OR] 2.44; 95% confidence interval [CI] 1.48-4.05; p < 0.001), low body mass index (BMI) (OR 0.83; 95% CI 0.70–0.98; p = 0.029), and type of surgery (OR 0.34; 95% CI 0.14–0.92; p = 0.033). The diagnostic accuracy of a reflux score of more than 2 was 81%, with a sensitivity, specificity, positive predictive value, and negative predictive value of 76%, 85%, 80%, and 82%, respectively. The likelihood ratio for a positive result was 5.05.

Conclusion

Hiatal hernia is common in this population of surgical patients undergoing an elective laparoscopy. Patients with reflux symptoms or a low BMI were more likely to have a hiatal hernia. With a reflux score of more than 2, the probability of finding a hiatal hernia during laparoscopy is 80%.
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Metadata
Title
Clinical relevance of laparoscopically diagnosed hiatal hernia
Authors
Yves Van Nieuwenhove
Jeroen Sonck
Boudewijn De Waele
Peter Potvlieghe
Georges Delvaux
Patrick Haentjens
Publication date
01-05-2009
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 5/2009
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-008-9970-4

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