KALA, Zdeněk, Jiří DOLINA, Petr KYSELA, Markéta HERMANOVÁ, Vladimír PROCHÁZKA, Radek KROUPA, Lydie IZAKOVIČOVÁ HOLLÁ and Aleš HEP. Intraoperative manometry of the lower esophageal sphincter pressure during laparoscopic antireflux surgery with a mechanical calibration--early results. Hepato-Gastroenterology. Athens-Stuttgart: H.G.E. Update Medical Publishing S.A. Athens-Stuttgart, 2006, vol. 53, No 71, p. 710-14, 5 pp. ISSN 0172-6390.
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Basic information
Original name Intraoperative manometry of the lower esophageal sphincter pressure during laparoscopic antireflux surgery with a mechanical calibration--early results.
Name in Czech Peroperační manometrie dolního jícnového svěrače během laparoskopické antirefluxní chirurgie s mechanickou kalibrací - časné výsledky.
Authors KALA, Zdeněk (203 Czech Republic, guarantor), Jiří DOLINA (203 Czech Republic), Petr KYSELA (203 Czech Republic), Markéta HERMANOVÁ (203 Czech Republic), Vladimír PROCHÁZKA (203 Czech Republic), Radek KROUPA (203 Czech Republic), Lydie IZAKOVIČOVÁ HOLLÁ (203 Czech Republic) and Aleš HEP (203 Czech Republic).
Edition Hepato-Gastroenterology, Athens-Stuttgart, H.G.E. Update Medical Publishing S.A. Athens-Stuttgart, 2006, 0172-6390.
Other information
Original language English
Type of outcome Article in a journal
Field of Study 30000 3. Medical and Health Sciences
Country of publisher Greece
Confidentiality degree is not subject to a state or trade secret
Impact factor Impact factor: 0.756
RIV identification code RIV/00216224:14110/06:00032297
Organization unit Faculty of Medicine
UT WoS 000241634500014
Keywords in English gastro-esophageal reflux; antireflux surgery; calibration; intraoperative manometry
Tags antireflux surgery, calibration, gastro-esophageal reflux, intraoperative manometry
Tags International impact
Changed by Changed by: prof. MUDr. Lydie Izakovičová Hollá, Ph.D., učo 734. Changed: 17/6/2009 11:38.
Abstract
Persistent postoperative dysphagia diminishes the good effect of laparoscopic anti-reflux surgery. An excessive increase of the intraoperative lower esophageal sphincter pressure (LESp) is supposed to be related to the persistent postoperative dysphagia and its knowledge could lead to the modification of the surgical technique followed by improved clinical outcomes. This study aims to describe the relation between the intraoperative LESp increase and the incidence of postoperative dysphagia and to find whether a combination of intraoperative manometry and mechanical calibration of the wrap is able to decrease the incidence of the persistent postoperative dysphagia. METHODOLOGY: The randomized, prospective, two-branch study included 39 patients suffering from symptoms of gastroesophageal reflux disease. All patients underwent pre- and postoperative manometry, 24-hour pH-metry and laparoscopic anti-reflux surgery. The intraoperative LESp was measured in the study arm only. RESULTS: A higher incidence of persistent postoperative dysphagia was revealed in patients with the intraoperative LESp increase more than 15 mmHg. This complication was not found in patients with the LESp increase under 8 mmHg with no impact on the efficacy of the surgery. The combination of the intraoperative manometry and the mechanical calibration of the wrap seems to bring the benefit only to a small number of the patients. CONCLUSIONS: According to our results, the intraoperative LESp measurement proved to be a useful supplementary method which was easy to perform, and which enables a modification of the surgical technique to decrease the incidence of the persistent postoperative dysphagia.
Abstract (in Czech)
Perzistující dysfagie po antirefluxní operaci zhoršuje funkční výsledek antirefluxní chirurgie. Pokud předpokládáme, že přílišný nárůst tlaku dolního jícnového svěrače behěme operace zvýší riziko pooperační dysfagie, mohlo by peroperační měření tohoto tlaku s možností okamžité modifikace operace k dosažení optimálního tlaku snížit pooperační výskyt dysfagie. Skutečně bylo prokázáno,. že vyšší riziko dysfagie je u púacientů s nárůstem peroperačního tlaku na 15mmHg, pacienti s tímto nárůstem pod 8mm Hg naopak žádnou dysfagií netrpěli a navíc u nich nebyl nalezen snížený efekt antirefluxního výkonu. U pacientů s rizikem pooperační dysfagie lez tedy metodu peroperační jícnové manometrie doporučit.
Links
2B06060, research and development projectName: Zefektivnění diagnostiky a léčby gastroezofageální refluxní choroby jícnu (Acronym: NPVII11002)
Investor: Ministry of Education, Youth and Sports of the CR
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