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Surgical Endoscopy
Published in: Surgical Endoscopy 10/2004

01-10-2004 | Original article

Effectiveness of esophageal manometry in predicting the outcome of children with primary GER after floppy Nissen-Rossetti wrap

Authors: G. Mattioli, V. Gentilino, E. Caponcelli, F. Martino, M. Castagnetti, A. PiniPrato, V. Jasonni

Published in: Surgical Endoscopy | Issue 10/2004

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Abstract

Background

Surgical treatment of gastroesophageal reflux (GER) can result in many postoperative problems because of an incorrect indication or an unsuitable fundoplication. Many preoperative tests have been suggested to perform a “tailored fundoplication,” but there is no clear evidence as to which is the best. The aim of our study was to define the effectiveness of esophageal manometry in predicting the outcome of children who need fundoplication because of refractory primary gastroesophageal reflux.

Methods

Thirty-two children were included in the study. Patients with gastroenterologic and respiratory symptoms numbered 10 (31%) and 22 (69%), respectively. The preoperative motility pattern was (1) inappropriate relaxations alone in nine patients (28%) and associated with esophageal body dysmotility in one patients (3%); (2) low-pressure lower esophageal sphincter (LES), alone in 13 patients (41%) and associated with body dysmotility in eight (25%). Motility pattern of the esophageal body was abnormal in nine children. Manometric anomalies were absent only in one case.

Results

Low pressure of the LES associated with atypical esophageal motility disorders was significantly higher in the gastroenterological group and in the older patients. Low pressure of the LES associated with good esophageal activity was significantly higher in the respiratory group and in the patients younger than 24 months. There was no correlation between motility pattern and outcome, and no statistically significant differences were found between pressure values at the different levels and symptoms, outcome, and age groups.

Conclusions

Esophageal manometry is not mandatory to predict the outcome of patients undergoing laparoscopic Nissen-Rossetti fundoplication for refractory primary GER treatment.
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Metadata
Title
Effectiveness of esophageal manometry in predicting the outcome of children with primary GER after floppy Nissen-Rossetti wrap
Authors
G. Mattioli
V. Gentilino
E. Caponcelli
F. Martino
M. Castagnetti
A. PiniPrato
V. Jasonni
Publication date
01-10-2004
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 10/2004
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-003-9307-2

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