Omari, T;
Connor, F;
McCall, L;
Ferris, L;
Ellison, S;
Hanson, B;
Abu-Assi, R;
... Moore, D; + view all
(2018)
A study of dysphagia symptoms and esophageal body function in children undergoing anti-reflux surgery.
United European Gastroenterology Journal
10.1177/2050640618764936.
(In press).
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Taher Omari Pediatric Gastroesophageal surgery reflux dysphagia submitted.pdf - Accepted Version Download (1MB) | Preview |
Abstract
Background: The role of high-resolution esophageal impedance manometry (HRIM) for establishing risk for dysphagia after anti-reflux surgery is unclear. We conducted a prospective study of children with primary gastroesophageal reflux (GER) disease, for whom symptoms of dysphagia were determined pre-operatively and then post-operatively and we examined for features that may predict post-operative dysphagia. Methods: Thirteen children (aged 6.8–15.5 years) undergoing work-up prior to 360 o Nissen fundoplication were included in the study. A dysphagia score assessed symptoms at pre-operative study and post-operatively (mean 1.4 years). A HRIM procedure recorded 5-ml liquid, 5-ml viscous and 2-cm solid boluses. We assessed esophageal motility, esophago-gastric junction (EGJ) morphology, EGJ contractility and pressure-flow variables indicative of bolus distension pressures and bolus clearance pressures. A composite pressure-flow index score was also derived. Results: Pre-operative pressure-flow index was positively correlated with post-operative dysphagia score (viscous bolus r = 0.771, p < 0.005). Of three variables that comprise the pressure-flow index, the ramp pressure measured during bolus clearance was the main driver of the effect seen (viscous bolus r = 0.819, p < 0.005). Conclusions: In order to mitigate symptoms in relation to anti-reflux surgery, dysphagia symptoms and esophageal function need to be pre-operatively assessed. In patients with normal motility, an elevated pressure-flow index may predict post-operative dysphagia.
| Type: | Article |
|---|---|
| Title: | A study of dysphagia symptoms and esophageal body function in children undergoing anti-reflux surgery |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1177/2050640618764936 |
| Publisher version: | https://doi.org/10.1177/2050640618764936 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Gastroesophageal reflux, fundoplication, dysphagia, diagnosis |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > UCL BEAMS UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Mechanical Engineering |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10045524 |
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