Article: The relationship between intra-operative manometry and clinical outcome in patients operated on for gastro-esophageal reflux disease

Lower esophageal sphincter pressure has been assessed pre-operatively, intra-operatively,and more than 6 months postoperatively in 34 patients having antireflux surgery for gastro-esophageal reflux disease. The sphincter pressures associated with the outcome in relation to pH measured reflux and the symptoms of recurrent heartburn, gas bloating, and dysphagia have been determined. There was no significant difference between the intra-operative sphincter pressure or the postoperative sphincter pressure and any of these parameters. It is concluded that intra-operative manometry in its present form is not useful in antireflux surgery for primary gastro-esophageal reflux disease.

Citing Articles

Laparoscopic Nissen fundoplication decreases gastroesophageal junction distensibility in patients with gastroesophageal reflux disease.

Blom D, Bajaj S, Liu J, Hofmann C, Rittmann T, Derksen T J Gastrointest Surg. 2005; 9(9):1318-25.

PMID: 16332489 DOI: 10.1016/j.gassur.2005.08.032.

Metabolic changes in the lower esophageal sphincter influencing the result of anti-reflux surgical interventions in chronic gastroesophageal reflux disease.

Altorjay A, Juhasz A, Kellner V, Sohar G, Fekete M, Sohar I World J Gastroenterol. 2005; 11(11):1623-8.

PMID: 15786538 PMC: 4305942. DOI: 10.3748/wjg.v11.i11.1623.

An ambulant porcine model of acid reflux used to evaluate endoscopic gastroplasty.

Kadirkamanathan S, Yazaki E, Evans D, Hepworth C, Gong F, Swain C Gut. 1999; 44(6):782-8.

PMID: 10323878 PMC: 1727549. DOI: 10.1136/gut.44.6.782.

Does modern technology belong in gastro-intestinal surgery? A step from subjective perception to objective information.

Hill L, Kraemer S World J Surg. 1992; 16(2):341-2.

PMID: 1561821 DOI: 10.1007/BF02071544.

References

1.

ALLISON P . Hiatus hernia: (a 20-year retrospective survey). Ann Surg. 1973; 178(3):273-6. PMC: 1355799. DOI: 10.1097/00000658-197309000-00006. View

2.

Bjerkeset T, Nordgard K, Schjonsby H . Effect of Nissen fundoplication operation on the competence of the lower esophageal sphincter. Scand J Gastroenterol. 1980; 15(2):213-7. DOI: 10.3109/00365528009181457. View

3.

SKINNER D, Booth D . Assessment of distal esophageal function in patients with hiatal hernia and-or gastroesophageal reflux. Ann Surg. 1970; 172(4):627-37. PMC: 1397316. DOI: 10.1097/00000658-197010000-00009. View

4.

Pettersson G, Bombeck C, Nyhus L . The lower esophageal sphincter: mechanisms of opening and closure. Surgery. 1980; 88(2):307-14. View

5.

Hill L, Asplund C, Roberts P . Intraoperative manometry: adjunct to surgery for esophageal motility disorders. Am J Surg. 1984; 147(1):171-4. DOI: 10.1016/0002-9610(84)90053-9. View

6.

Kiroff G, Maddern G, Jamieson G . A study of factors responsible for the efficacy of fundoplication in the treatment of gastro-oesophageal reflux. Aust N Z J Surg. 1984; 54(2):109-12. DOI: 10.1111/j.1445-2197.1984.tb06699.x. View

7.

Fisher R, Malmud L, Lobis I, Maier W . Antireflux surgery for symptomatic gastroesophageal reflux: mechanism of action. Am J Dig Dis. 1978; 23(2):152-60. DOI: 10.1007/BF01073192. View

8.

Jamieson G . Anti-reflux operations: how do they work?. Br J Surg. 1987; 74(3):155-6. DOI: 10.1002/bjs.1800740302. View

9.

Bancewicz J, Mughal M, Marples M . The lower oesophageal sphincter after floppy Nissen fundoplication. Br J Surg. 1987; 74(3):162-4. DOI: 10.1002/bjs.1800740304. View

10.

Hill L . Intraoperative measurement of lower esophageal spincter pressure. J Thorac Cardiovasc Surg. 1978; 75(3):378-82. View

11.

Dent J . A new technique for continuous sphincter pressure measurement. Gastroenterology. 1976; 71(2):263-7. View

12.

HIEBERT C, OMara C . The Belsey operation for hiatal hernia: a twenty year experience. Am J Surg. 1979; 137(4):532-5. DOI: 10.1016/0002-9610(79)90126-0. View

The Relationship Between Intra-operative Manometry and Clinical Outcome in Patients Operated on for Gastro-esophageal Reflux Disease