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Collagen type I:III ratio of the gastroesophageal junction in patients with paraesophageal hernias.
Surg Endosc. 2011 May; 25(5):1390-4.SE

Abstract

BACKGROUND

The purpose of this study was to examine the biological environment of the esophageal hiatus through analysis of the collagen content within the gastrohepatic ligament (GHL), gastrophrenic ligament (GPL), and phrenoesophageal ligament (PEL) in patients with type I hiatal hernias (HH) and type III paraesophageal hernias (PEH).

METHODS

A control group (N=10) and patients with type I HH (N=10) and type III PEH (N=10) were included in the analysis. Specimens of the GHL, PEL, and GPL were collected intraoperatively. Slides stained with sirius red/fast green were created and ten photos at 400×magnification were taken of each specimen. Axiovision 4.7 (Zeiss) photo analysis software was employed for quantification of collagen I (red) and III (green) by calculating color area (μm2). Statistical significance (p<0.05) was determined using a one-way ANOVA and Fisher's LSD post-test.

RESULTS

Cross-polarization microscopy revealed that the collagen I content was similar in the three study groups for the GHL, greater in the type III PEH group and in the control group compared to the type I HH group for the PEL, and greater in the type III PEH group compared to control group for the GPL. Collagen III quantity was greater in the control group than in the type I HH group for each ligament, and greater in the GHL and PEL when compared to the type III PEH group. Type III PEH patients had greater collagen III quantity than did type I HH patients for each ligament. Collagen type I:III ratio of the GHL was greater in both hernia groups compared to the control group. Type III PEH patients contained a higher I:III ratio than both the control and type I HH groups with respect to the PEL. There was no difference in the ratio with evaluation of the GPL for the three groups.

CONCLUSION

Evaluation of the esophageal hiatus revealed that patients with PEH have a different biological environment with regard to collagen content compared to control patients. The collagen I:III ratio of the study groups was equal to or greater than the control group. Collagen deficiency in the GE junction supporting ligaments does not appear to be an etiology of PEH formation.

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Authors+Show Affiliations

Brown SR
Section of Minimally Invasive Surgery, Department of Surgery, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box #8109, St. Louis, MO 63110, USA.
Melman L
No affiliation info available
Jenkins E
No affiliation info available
Deeken C
No affiliation info available
Frisella MM
No affiliation info available
Brunt LM
No affiliation info available
Eagon JC
No affiliation info available
Matthews BD
No affiliation info available

MeSH

Collagen Type ICollagen Type IIIEsophagogastric JunctionFemaleHernia, HiatalHumansLaparoscopyLigamentsMaleMiddle Aged

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21046161

Citation

Brown, Shaun R., et al. "Collagen Type I:III Ratio of the Gastroesophageal Junction in Patients With Paraesophageal Hernias." Surgical Endoscopy, vol. 25, no. 5, 2011, pp. 1390-4.
Brown SR, Melman L, Jenkins E, et al. Collagen type I:III ratio of the gastroesophageal junction in patients with paraesophageal hernias. Surg Endosc. 2011;25(5):1390-4.
Brown, S. R., Melman, L., Jenkins, E., Deeken, C., Frisella, M. M., Brunt, L. M., Eagon, J. C., & Matthews, B. D. (2011). Collagen type I:III ratio of the gastroesophageal junction in patients with paraesophageal hernias. Surgical Endoscopy, 25(5), 1390-4. https://doi.org/10.1007/s00464-010-1373-7
Brown SR, et al. Collagen Type I:III Ratio of the Gastroesophageal Junction in Patients With Paraesophageal Hernias. Surg Endosc. 2011;25(5):1390-4. PubMed PMID: 21046161.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Collagen type I:III ratio of the gastroesophageal junction in patients with paraesophageal hernias. AU - Brown,Shaun R, AU - Melman,Lora, AU - Jenkins,Eric, AU - Deeken,Corey, AU - Frisella,Margaret M, AU - Brunt,L Michael, AU - Eagon,J Christopher, AU - Matthews,Brent D, Y1 - 2010/11/03/ PY - 2010/04/21/received PY - 2010/09/12/accepted PY - 2010/11/4/entrez PY - 2010/11/4/pubmed PY - 2011/8/13/medline SP - 1390 EP - 4 JF - Surgical endoscopy JO - Surg Endosc VL - 25 IS - 5 N2 - BACKGROUND: The purpose of this study was to examine the biological environment of the esophageal hiatus through analysis of the collagen content within the gastrohepatic ligament (GHL), gastrophrenic ligament (GPL), and phrenoesophageal ligament (PEL) in patients with type I hiatal hernias (HH) and type III paraesophageal hernias (PEH). METHODS: A control group (N=10) and patients with type I HH (N=10) and type III PEH (N=10) were included in the analysis. Specimens of the GHL, PEL, and GPL were collected intraoperatively. Slides stained with sirius red/fast green were created and ten photos at 400×magnification were taken of each specimen. Axiovision 4.7 (Zeiss) photo analysis software was employed for quantification of collagen I (red) and III (green) by calculating color area (μm2). Statistical significance (p<0.05) was determined using a one-way ANOVA and Fisher's LSD post-test. RESULTS: Cross-polarization microscopy revealed that the collagen I content was similar in the three study groups for the GHL, greater in the type III PEH group and in the control group compared to the type I HH group for the PEL, and greater in the type III PEH group compared to control group for the GPL. Collagen III quantity was greater in the control group than in the type I HH group for each ligament, and greater in the GHL and PEL when compared to the type III PEH group. Type III PEH patients had greater collagen III quantity than did type I HH patients for each ligament. Collagen type I:III ratio of the GHL was greater in both hernia groups compared to the control group. Type III PEH patients contained a higher I:III ratio than both the control and type I HH groups with respect to the PEL. There was no difference in the ratio with evaluation of the GPL for the three groups. CONCLUSION: Evaluation of the esophageal hiatus revealed that patients with PEH have a different biological environment with regard to collagen content compared to control patients. The collagen I:III ratio of the study groups was equal to or greater than the control group. Collagen deficiency in the GE junction supporting ligaments does not appear to be an etiology of PEH formation. SN - 1432-2218 UR - https://www.unboundmedicine.com/medline/citation/21046161/Collagen_type_I:III_ratio_of_the_gastroesophageal_junction_in_patients_with_paraesophageal_hernias_ L2 - https://doi.org/10.1007/s00464-010-1373-7 DB - PRIME DP - Unbound Medicine ER -