Please use this identifier to cite or link to this item:
https://hdl.handle.net/2440/78896
Citations | ||
Scopus | Web of Science® | Altmetric |
---|---|---|
?
|
?
|
Type: | Journal article |
Title: | Gastroesophageal reflux, esophageal function, gastric emptying, and the relationship to dysphagia before and after antireflux surgery in children |
Author: | Loots, C. Van Herwaarden, M. Benninga, M. VanderZee, D. van Wijk, M. Omari, T. |
Citation: | Journal of Pediatrics, 2013; 162(3):566-573 |
Publisher: | Mosby Inc |
Issue Date: | 2013 |
ISSN: | 0022-3476 1097-6833 |
Statement of Responsibility: | Clara Loots, Maud Y. van Herwaarden, Marc A. Benninga, David C. VanderZee, Michiel P. van Wijk, and Taher I. Omari |
Abstract: | <h4>Objectives</h4>To assess gastroesophageal reflux (GER), esophageal motility, and gastric emptying in children before and after laparoscopic fundoplication and to identify functional measures associated with postoperative dysphagia.<h4>Study design</h4>Combined impedance-manometry, 24-hour pH-impedance, and gastric-emptying breath tests were performed before and after laparoscopic anterior partial fundoplication. Impedance-manometry studies were analyzed with the use of conventional analysis methods and a novel automated impedance manometry (AIM) analysis.<h4>Results</h4>Children with therapy resistent GER disease (n = 25) were assessed before fundoplication, of whom 10 (median age 6.4 years; range, 1.1-17.1 years; 7 male; 4 with neurologic impairment) underwent fundoplication. GER episodes reduced from 97 (69-172) to 66 (18-87)/24 hours (P = .012). Peristaltic contractions were unaltered. Complete lower esophageal sphincter relaxations decreased after fundoplication (92% [76%-100%] vs 65% [29%-91%], P = .038). Four (40%) patients developed postoperative dysphagia, which was transient in 2. In those patients, preoperative gastric emptying was delayed compared with patients without postoperative dysphagia, 96 minutes (71-104 minutes) versus 48 minutes (26-68 minutes), P = .032, and AIM analysis derived dysphagia risk index was greater (56 [15-105] vs 2 [2-6] P = .016). Two patients underwent a repeat fundoplication.<h4>Discussion</h4>Fundoplication in children reduced GER without altering esophageal motility. Four patients who developed dysphagia demonstrated slower gastric emptying and greater dysplasia risk index preoperatively. AIM analysis may allow detection of subtle esophageal abnormalities potentially leading to postoperative dysphagia. |
Keywords: | Esophagus Humans Deglutition Disorders Gastroesophageal Reflux Laparoscopy Treatment Outcome Fundoplication Manometry Gastric Emptying Adolescent Child Child, Preschool Infant Female Male |
Rights: | Copyright © 2013 Mosby Inc. |
DOI: | 10.1016/j.jpeds.2012.08.045 |
Published version: | http://dx.doi.org/10.1016/j.jpeds.2012.08.045 |
Appears in Collections: | Aurora harvest 4 Paediatrics publications |
Files in This Item:
There are no files associated with this item.
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.