Electromanometry and acid pHmetry of 24 hours in postoperative evaluation of the hiatoplasty and total antireflux wrap laparoscopic

• Published in: Arquivos de gastroenterologia Vol. 43; no. 2; pp. 112 - 116
• Main Authors: Pastore, Ricardo, Crema, Eduardo, Silveira, Mariana de Carvalho, Presoto, Adriana Ferreira, Herbella, Fernando Augusto Mardiros, Del Grande, José Carlos
• Format: Journal Article
• Language: Portuguese
• Published: Brazil 01.04.2006
• Subjects: Adult; Aged; Female; Follow-Up Studies; Fundoplication - methods; Gastroesophageal Reflux - surgery; Humans; Hydrogen-Ion Concentration; Laparoscopy - methods; Male; Manometry - methods; Middle Aged; Postoperative Period; Prospective Studies; Treatment Outcome
• ISSN: 0004-2803; 1678-4219
• DOI: 10.1590/s0004-28032006000200010

The electromanometry and 24-hour esophageal pHmetry has been proposed as objective method in postoperative evaluation of antireflux surgery. Prospective evaluation of the results of cruroplasty and total fundoplication in the treatment of non-complicated gastroesophageal reflux disease based on comparative results of pre and post operative manometry and pHmetry findings. Fifty-nine consecutive individuals with typical symptoms of gastroesophageal reflux disease were prospectively studied. All patients were submitted to a laparoscopic short floppy Nissen fundoplication between March, 2002 and August, 2003. All patients were submitted pre and postoperatively (3 months) to upper digestive endoscopy, manometry and pHmetry 24 hours. Eighteen (30.5%) patients were male and 41 (69.5%) female, their average age was 43.8 years. There were differences comparing the pre and post operative period in the manometrical findings in the following items: localization of the lower esophageal sphincter (41.2 cm and 42.3 cm). Extension o f the lower esophageal sphincter preoperative (2.0 cm and 2.5 cm), resting pressure of the lower esophageal sphincter (15.0 mm Hg and 21.5 mm Hg), and pressure of the esophageal body (78.0 mm Hg and 70.0 mm Hg). There were differences comparing the pre and post operative period in the pHmetrical findings in the following items: total number of acid refluxes (68.0 and 3.0), total number of acid refluxes more than 5 minutes (2.0 and 0.0), acid reflux more than 5 minutes in supine position (1.0 and 0.0), acid reflux more than 5 minutes in upright position (0.0 and 0.0), acidification period (5.5 and 0.1 min), DeMeester score (33.0 and 0.8). The esophageal manometry and pHmetry findings were improved in the post operative period with statistical significance when compared to the pre operative period. The exams were considered efficient in the evaluation of the surgical procedure.