Extended hiatoplasty - A simple maneuver to lengthen the intraabdominal esophagus during abdominal fundoplication

Aim: The aim of this paper is to describe a simple technique of extended hiatoplasty to achieve intraabdominal placement of the distal esophagus and evaluate it manometricaly. Methods: Twelve mongrel dogs were submitted to esophageal manometry using a balloon system and continuous pull-through technique, before and after being submitted to laparotomy and extended hiatoplasty. Parameters measured included length of the HPZ, maximal recorded pressure and maximal end-expiratory pressure. Pre- and postoperative values were compared using the Wilcoxon nonparametric test accepting 0.05 as a level of significance. Results: There was a significant post-operative increase in the length of the HPZ from 48.22 (+/-4.33) mm to 68.69 (+/-14.17)mm (p < 0.05). No significant change in the recorded values of maximal pressure or maximal end-expiratory pressure could be detected. The results indicate that an additional portion of the esophagus was exposed to the positive intraabdominal pressure and that this extended hiatoplasty can be used, together with a fundoplication, to increase the efficacy of the gastro-esophageal barrier.o TEXTO COMPLETO DESTE ARTIGO, ESTARÁ DISPONÍVEL À PARTIR DE AGOSTO DE 2015.8530430