title: Oesophageal and cardia function in patients with paraoesophageal hiatus hernia.
abstract: BACKGROUND
  The decision to add an antireflux procedure when a paraoesophageal hernia is repaired is still controversial. The aim of this study was to investigate oesophageal and cardia function in these patients to verify whether fundoplication was needed.
  
  
  METHODS
  Eighteen patients with paraoesophageal hernia were evaluated by oesophageal manometry, 24-h pH monitoring, endoscopy and barium swallow. All patients underwent surgery including antireflux fundoplication. Fourteen patients with sliding hernia plus reflux disease and 16 healthy volunteers formed the control groups.
  
  
  RESULTS
  Patients with paraoesophageal hernia had a shorter lower oesophageal sphincter and a greater acid exposure than healthy controls (P < 0.05). Fifteen of 18 patients had either abnormal acid exposure and/or a defective lower oesophageal sphincter at manometry. Postfundoplication symptoms were observed in only one of 16 patients at 6 months' follow-up.
  
  
  CONCLUSIONS
  Since 15 of 18 patients had abnormal acid exposure or were considered prone to developing gastro-oesophageal reflux disease because of a defective lower oesophageal sphincter, this study strongly supports the need to add an antireflux operation to hernia repair.
authors.affiliation: Department of Surgery, University of Padua School of Medicine, Padova, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Zaninotto
authors.forename: M
authors.initials: M
authors.lastname: Costantini
authors.forename: M
authors.initials: M
authors.lastname: Anselmino
authors.forename: C
authors.initials: C
authors.lastname: Boccù
authors.forename: D
authors.initials: D
authors.lastname: Molena
authors.forename: P
authors.initials: P
authors.lastname: Rigotti
authors.forename: S
authors.initials: S
authors.lastname: Merigliano
authors.forename: E
authors.initials: E
authors.lastname: Ancona
mesh_terms: D000328:Adult; D000368:Aged; D002299:Cardia / Q000503:physiopathology; D004947:Esophagus / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D018662:Fundoplication; D005764:Gastroesophageal Reflux / Q000503:physiopathology* / Q000601:surgery; D006356:Heartburn / Q000209:etiology / Q000503:physiopathology; D006551:Hernia, Hiatal / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008365:Manometry; D008875:Middle Aged; D010528:Peristalsis / Q000502:physiology; D011312:Pressure; D016896:Treatment Outcome