title: [Quantitative microscopic modifications of the diaphragm and the paraesophageal structures in hiatal hernia. Clinical aspects].
abstract: In the last decade has seen an increase in hiatal hernia diagnosis. These issues led us to study and deepen the anatomic substrate of the changes that occur in the diaphragm muscle and periesophageal structures for optimum management of the disorder. The studied material was represented by fragments of the thoraco-abdominal diaphragm and tissues around the esophagus, biopsy sampling by classic open approach or celioscopic in patients with hiatal hernia, compared with a control group. Histological processing was carried out by current or special methods. After qualitative examining of the selected structures, quantification was performed using an interactive digital program. In the adult diaphragm with hiatal hernia was found in percentage volume reduction pillar of the diaphragm muscle fibers, increased the percentage of vascular lumina in the muscle portion of the crura, while the percentage volume of interstitial spaces increase. The changes of the percentage volume of connective tissue are significant, both crura suffering a fibrous transformation of muscle portions. Microanatomic changes are their quantitative objectivity suggest loss of elasticity and reduced functional capacity of diaphragm muscle in hiatal hernias.
authors.affiliation: Clinical I Chirurgie, Spitalul Clinic de Urgenţ Sf. Apostol Andrei, Galaţi. valeriu_ar@yahoo.com
authors.forename: V
authors.initials: V
authors.lastname: Ardeleanu
authors.forename: G R
authors.initials: GR
authors.lastname: Chebac
authors.forename: L L
authors.initials: LL
authors.lastname: Frâncuz
authors.forename: D
authors.initials: D
authors.lastname: Păduraru
authors.forename: C
authors.initials: C
authors.lastname: Georgescu
authors.forename: L D
authors.initials: LD
authors.lastname: Frâncu
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D003964:Diaphragm / Q000473:pathology*; D004947:Esophagus / Q000473:pathology*; D006551:Hernia, Hiatal / Q000473:pathology* / Q000601:surgery; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity