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Hiatal hernia.

Toshihiro Nishizawa, Hidekazu Suzuki

    Nihon Rinsho. Japanese Journal of Clinical Medicine
    |December 19, 2018
    PubMed
    Summary

    Hiatal hernias occur when abdominal contents, primarily the stomach, move into the chest. Anti-reflux mucosectomy (ARMS) shows promise as an effective anti-reflux procedure for managing hiatal hernias.

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    Area of Science:

    • Gastroenterology
    • Surgical Innovation

    Background:

    • Hiatal hernias involve abdominal organs, typically the stomach, herniating into the mediastinum via the esophageal hiatus.
    • Type I hiatal hernias are most prevalent (85-95%), while Types II, III, and IV are forms of paraesophageal hernias.

    Purpose of the Study:

    • To review the diagnosis and management of hiatal hernias.
    • To evaluate the efficacy of anti-reflux mucosectomy (ARMS) as a treatment.

    Main Methods:

    • Diagnosis of sliding hiatal hernia via endoscopy (Makuuchi classification: >3 cm axial span; Western countries: >2 cm).
    • High-resolution manometry with pressure topography plotting for precise esophagogastric junction assessment.

    Main Results:

    • Sliding hiatal hernias are diagnosed endoscopically based on axial span.
    • High-resolution manometry offers detailed physiological evaluation of the esophagogastric junction.

    Conclusions:

    • Anti-reflux mucosectomy (ARMS) is a potentially effective anti-reflux procedure for hiatal hernias.
    • Accurate diagnosis and physiological assessment are crucial for managing hiatal hernias.

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