0bjecfive To explore the clinical basis for the diagnosis of gastroesophageal reflux disease combined with hiatal hernia and the selection of laparoscopic fundus folding surgery by high-resolution esophageal manometer (HRM) combined with 24-hour pH impedance technique.

From April 2015 to October 2019,167 patients were diagnosed with gastroesophageal reflux disease combined with hiatal hernia and performed operations in Weifang people's hospital. The diagnosis rate of gastroesophageal reflux disease combined with hiatal hernia by gastroscopy and HRM combined with 24-hour pH impedance was calculated, and the status and role of gastroesophageal reflux disease combined with hiatal hernia in minimally invasive treatment of hiatal hernia were summarized.

The detection rate of HRM combined with 24-Hour pH impedance technique was 83.32% (139/167), and the specificity was 100% (139/139),and the confirmed by gastroscopy was 67.06% (112/167).Among them,112 patients were diagnosed by gastroscopy and HRM ,accounting for 80.57% (112/139).The detection rate of HRM combined with 24-Hour pH impedance technique was significantly higher than gastroscopy;105 cases were treated with laparoscopic esophageal hiatal hernia repair combined with gastric fundus folding ,and 7 patients gave up surgery to choose conservative treatment.

Compared with gastroscope, HRM examination combined with 24-hour pH impedance technique has higher specificity in the diagnosis of gastroesophageal reflux disease combined with hiatal hernia, and can effectively guide the gastric fundus folding operation..