UCL Discovery
UCL home » Library Services » Electronic resources » UCL Discovery

A study of dysphagia symptoms and esophageal body function in children undergoing anti-reflux surgery

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). Green open access

[img]
Preview
Text
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 > Provost and Vice Provost Offices
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
Downloads since deposit
52Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item