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Clinical relevance of laparoscopically diagnosed hiatal hernia

Surgical Endoscopy volume 23, pages 1093–1098 (2009)Cite this article

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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Affiliations

  1. Department of Surgery, Universitair Ziekenhuis Brussels, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium

    Yves Van Nieuwenhove, Jeroen Sonck, Boudewijn De Waele, Georges Delvaux & Patrick Haentjens

  2. Department of Surgery, Aalsters Stedelijk Ziekenhuis, Merestraat 80, 9300, Aalst, Belgium

    Peter Potvlieghe

Authors
  1. Yves Van Nieuwenhove
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  2. Jeroen Sonck
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  3. Boudewijn De Waele
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  4. Peter Potvlieghe
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  5. Georges Delvaux
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  6. Patrick Haentjens
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Correspondence to Yves Van Nieuwenhove.

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Van Nieuwenhove, Y., Sonck, J., De Waele, B. et al. Clinical relevance of laparoscopically diagnosed hiatal hernia. Surg Endosc 23, 1093–1098 (2009). https://doi.org/10.1007/s00464-008-9970-4

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  • DOI: https://doi.org/10.1007/s00464-008-9970-4

Keywords

  • Laparoscopy
  • Hiatal hernia
  • Gastroesopheageal reflux
  • Diagnosis