Accuracy of High-Resolution Manometry in Hiatal Hernia Diagnosis in Primary and Revision Bariatric Surgery

Purpose There is a complex association between obesity, hiatal hernia (HH), and reflux. There is a deficiency of literature on the accuracy of preoperative high-resolution manometry (HRM) in detecting HH before both primary and revision bariatric surgery. Materials and Methods A retrospective analys...

Full description

Saved in:
Bibliographic Details
Published in:Obesity surgery 2021-07, Vol.31 (7), p.2906-2912
Main Authors: Chan, Daniel L., Chern, Tien Y., Iliopoulos, Jim, Hennessy, Annemarie, Wong, Simon K. H., Ng, Enders K. W., Talbot, Michael L.
Format: Article
Language:English
Subjects:
Accuracy
Fish oils
Gastrointestinal surgery
Hiatal hernias
Medicine
Medicine & Public Health
Original Contributions
Surgery
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Purpose There is a complex association between obesity, hiatal hernia (HH), and reflux. There is a deficiency of literature on the accuracy of preoperative high-resolution manometry (HRM) in detecting HH before both primary and revision bariatric surgery. Materials and Methods A retrospective analysis of a prospective database of all HRM performed before bariatric surgery from 2014 to 2019. An electronic medical records review was conducted. Sensitivity, specificity, and global diagnostic test accuracy were calculated. Results Sixty-seven patients with HRM (mean age of 44.0 ± 11.3 years, body mass index 40.8 ± 6.9 kg/m 2 ) were eligible. Intraoperative diagnosis of HH was made in 37 patients (55.2% prevalence). The HRM sensitivity was 48.7% (95% confidence interval (CI) 31.9–65.6%), specificity 90.0% (95% CI 73.5–97.9%), and accuracy was 67.2% (95% CI 54.6–78.2%). Comparing primary (28) and revision (39) surgery, the sensitivity (37.5% vs 57.1%), specificity (75.0% vs 100%), and diagnostic accuracy (54.3% vs 76.3%) were comparable, with overlapping 95% CI. Endoscopy performed in 30 patients had a sensitivity of 25.5% (95% CI 6.8–49.9%), specificity of 100% (95% CI 75.3–100%), and accuracy of 57.8% (95% CI 38.5–75.5%) and was comparable to HRM. Conclusion High-resolution manometry for the detection of HH before bariatric surgery has a high specificity and maintains a high accuracy in both primary and revision bariatric surgery. Graphical abstract
ISSN:0960-8923
1708-0428
DOI:10.1007/s11695-021-05335-8