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Jonathan Tiong
Monash Health, Australia
Posters & Accepted Abstracts: J Hepato Gastroenterol
Introduction: The incidence of hiatus hernia and gastro-oesophageal reflux disease (GORD) is high, up to 60% over the age of 50. Guidelines suggest that both manometry and contrast swallow (CS) should be employed in the surgical work up. In particular, manometric studies have been posited to assess the integrity of oesophageal peristalsis and evaluate the presence of achalasia. However, access to manometry studies is difficult and often costly, and concomitant achalasia and hiatus hernia is uncommon. In our study, we aim to determine the relationship between CS and/or manometry and subsequent operative management. Methods: Patients 18 years and older who underwent laparoscopic hiatus hernia repair and fundoplication were included. Data was collected retrospectively from Monash health over the past 5 years. Patients were divided into groups based on investigations: CS only, manometry only or both. Outcomes evaluated were method of fundoplication and presence of postoperative dysphagia. Results: 114 patients were included in the study. 40 patients had contrast swallow only, 41 had manometry only and 33 had both investigations. There were no significant differences in rates of post operative dysphagia. There was no significant difference in the fundoplication method utilised. Conclusion: Although numerous recommendations for preoperative workup of patients with hiatus hernia and GORD have been published, few studies have investigated the need for mandatory manometry. In patients presenting with GORD and hiatus hernia for elective repair, judicious use of manometry is safe.
Tiong is an unaccredited General Surgery trainee in Melbourne, Australia with a keen interest in upper GI and hepatobiliary diseases.
