Comparative assessment of the diagnostic methods for measuring the area of the esophageal opening of the diaphragm in patients with paraesophageal hernia
DOI:
https://doi.org/10.11603/2414-4533.2023.3.14142Keywords:
hernia of the esophageal opening of the diaphragm, laparoscopic hernioplasty, the area of the esophageal opening of the diaphragm, area measurementAbstract
The aim of the work: to compare the area of the esophageal opening of the diaphragm (EOD) in patients with type III paraesophageal hernias (PEH) according to the data of preoperative and intraoperative measurements.
Materials and methods. In the surgical clinic of the National medical university, including the period from 2016 to 2021, measurements of the EOD area were measured in 63 patients with type III PEH, using multispiral computed tomography (MSCT), esophagogastrofibroscopy (EGFS) and intraoperatively during planned laparoscopic hernioplasty (according to the Granderath method and measurment of the rhombus area – MRA). Among the patients, there were 41.3 % men and 58.7 % women with an average age of (53.8±10.8) years and a body mass index (BMI) of (29.6±4.9) kg/m2.
Results and discussion. A strong association was established between the exponents of MSCT and other methods: according to EGFS, linear R2 = 0.843, using the Granderath method – R2 = 0.872, according to MRA method – R2 = 0.778. At the same time, the exponents of the EOD area revealed a certain difference depending on the applied method.
The highest average exponent of the EOD area compared to other methods (all p <0.01) was obtained according to MSCT data – (13.01±3.04) cm3 (from 8.4 cm 3 to 29.1 cm2). Moreover, the area of EOD according to MSCT was larger compared to other methods for each participant. In particular, this results exceeded measured by the Granderath method exponents by an average of (33.2±5.1) % (from 15 % to 54 %).
The smallest average exponent of the EOD area, that was obtained, using EGFS, was (7.88±1.63) cm2 (from 5.2 to 15.2 cm2), which was significantly different from the results, measured by the MRA method – (8.72±1.67) cm2 (from 5.8 to 15.4 cm2 ), and did not statistically differ according to the exponents, that were obtained by the Granderath method – (8.16±1.71) cm2 (from 5.8–16.3 cm2 ). The average EOD area result, measured by the MRA intraoperative wasn’t statistically different (p >0.05).
Average measurement of the EOD area in patients with type III PEH was different depending on the method that was used: the largest measurement was obtained according to MSCT data – (13.01±3.04) cm3, the smallest – using EGFS – (7.88±1.63) cm2. Average exponent of the EOD area during intraoperative measurement: according to Granderath method (8.16±1.71 cm2) and according to the MRA method (8.72±1.67 cm2) were not statistically different.
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