The Effect of Deep Sedation in Endoscopic Diagnosis of Hiatal Hernia

Objective: Compliance of the patient with endoscopic examination may significantly affect the diagnosis of hiatal hernia. In this study, we had 2 aims: first, to investigate the effect of deep sedation on the esophagogastric junction to prevent changes in anatomical landmarks due to movements caused by coughing or retching, and second, to show the effect of experience in the evaluation of the esophagogastric junction.

Methods: Endoscopy records of 10 359 sequential patients were screened in the database of Gazi University Faculty of Medicine Department of Gastroenterology between January 2016 and February 2019, and 4083 patients with various indications aged 18 and over were included in the study. There were 4 patient groups; deep-sedated and non-deep-sedated patient groups were divided into subgroups of experienced and inexperienced endoscopists.

Results: The frequency of hiatal hernia was significantly lower in the deep-sedated group than in the non-deep-sedated group (7.2% vs. 16%, respectively) (P < .001). Similarly, the frequency of esophagitis was significantly lower in the deep-sedated group (13.5% vs. 21.7%, respectively) (P < .001). Experienced endoscopists were more likely to detect both hiatal hernia and esophagitis in deep-sedated and non-deep-sedated groups.

Conclusion: We demonstrated that the diagnosis of hiatal hernia and esophagitis was significantly increased when it was performed without deep sedation. Patient compliance during endoscopy is important to ensure that the anatomic landmarks do not move.

Cite this article as: Kılıç GE, Doğan İ, Kılıç G, et al. The effect of deep sedation in endoscopic diagnosis of hiatal hernia. Diagn Interv Endosc. 2022;1(3):62-65.