Esophageal mucosal integrity improves after laparoscopic antireflux surgery in children with gastroesophageal reflux disease
Background Esophageal intraluminal baseline impedance reflects the conductivity of the esophageal mucosa and may be an instrument for in vivo evaluation of mucosal integrity in children with gastroesophageal reflux disease (GERD). Laparoscopic antireflux surgery (LARS) is a well-established treatmen...
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| creator | Mauritz, Femke A. Rinsma, Nicolaas F. van Heurn, Ernest L. W. Sloots, Cornelius E. J. Siersema, Peter D. Houwen, Roderick H. J. van der Zee, David C. Masclee, Ad A. M. Conchillo, José M. Van Herwaarden-Lindeboom, Maud Y. A. |
| description | Background
Esophageal intraluminal baseline impedance reflects the conductivity of the esophageal mucosa and may be an instrument for in vivo evaluation of mucosal integrity in children with gastroesophageal reflux disease (GERD). Laparoscopic antireflux surgery (LARS) is a well-established treatment option for children with proton pump inhibitory (PPI) therapy resistant GERD. The effect of LARS in children on baseline impedance has not been studied in detail. The aim of this study was to evaluate the effect of LARS on baseline impedance in children with GERD.
Methods
This is a prospective, multicenter, nationwide cohort study (
Dutch national trial registry
:
NTR2934
) including 25 patients [12 males, median age 6 (range 2–18) years] with PPI-resistant GERD scheduled to undergo LARS. Twenty-four hour multichannel intraluminal impedance pH monitoring (MII-pH monitoring) was performed before and 3 months after LARS. Baseline impedance was evaluated during consecutive 2-h intervals in the 24-h tracings.
Results
LARS reduced acid exposure time from 8.5 % (6.0–16.2 %) to 0.8 % (0.2–2.8 %),
p
|
| doi_str_mv | 10.1007/s00464-016-5304-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5487897</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1835533037</sourcerecordid><originalsourceid>FETCH-LOGICAL-c540t-384939b16579a3f6ecfa20043b24d3627be4953b766c693b9a3252eca66752723</originalsourceid><addsrcrecordid>eNp1kU1rFTEUhoNY7LX6A9xIwI2bsfnOZCNIqR9Q6EbXIZN7Zm7KTDImM9WCP95c7rVWodmcwHnOez5ehF5R8o4Sos8LIUKJhlDVSE7q5wnaUMFZwxhtn6INMZw0TBtxip6XckMqbqh8hk6Zbokggm3Qr8uS5p0bwI14Wn0qNYa4wJDDcofDNOd0CwW7foGMRze7nIpPc_DYxSVk6Mf1Jy5rHiBXPGK_C-M2Q8Q_wrLDgytLTvC3xbFgGwq4Ai_QSe_GAi-P8Qx9-3j59eJzc3X96cvFh6vGS0GWhrfCcNNRJbVxvFfge8fqLrxjYssV0x0II3mnlfLK8K5CTDLwTiktmWb8DL0_6M5rN8HWQ1yyG-2cw-TynU0u2H8zMezskG6tFK1uja4Cb48COX1foSx2CsXDOLoIaS2WtlxKzgnfo2_-Q2_SmmNdz1JD6-OU80rRA-XrPUu9yv0wlNi9t_bgra3e2r23ltSa1w-3uK_4Y2YF2AEoNRWrIw9aP6r6G4cSsgQ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1911113133</pqid></control><display><type>article</type><title>Esophageal mucosal integrity improves after laparoscopic antireflux surgery in children with gastroesophageal reflux disease</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Mauritz, Femke A. ; Rinsma, Nicolaas F. ; van Heurn, Ernest L. W. ; Sloots, Cornelius E. J. ; Siersema, Peter D. ; Houwen, Roderick H. J. ; van der Zee, David C. ; Masclee, Ad A. M. ; Conchillo, José M. ; Van Herwaarden-Lindeboom, Maud Y. A.</creator><creatorcontrib>Mauritz, Femke A. ; Rinsma, Nicolaas F. ; van Heurn, Ernest L. W. ; Sloots, Cornelius E. J. ; Siersema, Peter D. ; Houwen, Roderick H. J. ; van der Zee, David C. ; Masclee, Ad A. M. ; Conchillo, José M. ; Van Herwaarden-Lindeboom, Maud Y. A.</creatorcontrib><description>Background
Esophageal intraluminal baseline impedance reflects the conductivity of the esophageal mucosa and may be an instrument for in vivo evaluation of mucosal integrity in children with gastroesophageal reflux disease (GERD). Laparoscopic antireflux surgery (LARS) is a well-established treatment option for children with proton pump inhibitory (PPI) therapy resistant GERD. The effect of LARS in children on baseline impedance has not been studied in detail. The aim of this study was to evaluate the effect of LARS on baseline impedance in children with GERD.
Methods
This is a prospective, multicenter, nationwide cohort study (
Dutch national trial registry
:
NTR2934
) including 25 patients [12 males, median age 6 (range 2–18) years] with PPI-resistant GERD scheduled to undergo LARS. Twenty-four hour multichannel intraluminal impedance pH monitoring (MII-pH monitoring) was performed before and 3 months after LARS. Baseline impedance was evaluated during consecutive 2-h intervals in the 24-h tracings.
Results
LARS reduced acid exposure time from 8.5 % (6.0–16.2 %) to 0.8 % (0.2–2.8 %),
p
< 0.001. Distal baseline impedance increased after LARS from 2445 Ω (1147–3277 Ω) to 3792 Ω (3087–4700 Ω),
p
< 0.001. Preoperative baseline impedance strongly correlated with acid exposure time (
r
−0.76,
p
< 0.001); however, no association between symptomatic outcome and baseline impedance was identified.
Conclusions
LARS significantly increased baseline impedance likely reflecting recovery of mucosal integrity. As the change in baseline impedance was not associated with the clinical outcome of LARS, other factors besides mucosal integrity may contribute to symptom perception in children with GERD.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-016-5304-0</identifier><identifier>PMID: 27804042</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Abdominal Surgery ; Adolescent ; Child ; Child, Preschool ; Electric Impedance ; Esophageal Mucosa - physiopathology ; Esophageal pH Monitoring - methods ; Esophagus ; Female ; Follow-Up Studies ; Fundoplication - methods ; Gastroenterology ; Gastroesophageal reflux ; Gastroesophageal Reflux - diagnosis ; Gastroesophageal Reflux - physiopathology ; Gastroesophageal Reflux - surgery ; Gynecology ; Hepatology ; Humans ; Laparoscopy ; Male ; Medicine ; Medicine & Public Health ; Proctology ; Prospective Studies ; Surgery ; Treatment Outcome</subject><ispartof>Surgical endoscopy, 2017-07, Vol.31 (7), p.2910-2917</ispartof><rights>The Author(s) 2016</rights><rights>Surgical Endoscopy is a copyright of Springer, 2017.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c540t-384939b16579a3f6ecfa20043b24d3627be4953b766c693b9a3252eca66752723</citedby><cites>FETCH-LOGICAL-c540t-384939b16579a3f6ecfa20043b24d3627be4953b766c693b9a3252eca66752723</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-016-5304-0$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-016-5304-0$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27804042$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mauritz, Femke A.</creatorcontrib><creatorcontrib>Rinsma, Nicolaas F.</creatorcontrib><creatorcontrib>van Heurn, Ernest L. W.</creatorcontrib><creatorcontrib>Sloots, Cornelius E. J.</creatorcontrib><creatorcontrib>Siersema, Peter D.</creatorcontrib><creatorcontrib>Houwen, Roderick H. J.</creatorcontrib><creatorcontrib>van der Zee, David C.</creatorcontrib><creatorcontrib>Masclee, Ad A. M.</creatorcontrib><creatorcontrib>Conchillo, José M.</creatorcontrib><creatorcontrib>Van Herwaarden-Lindeboom, Maud Y. A.</creatorcontrib><title>Esophageal mucosal integrity improves after laparoscopic antireflux surgery in children with gastroesophageal reflux disease</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Background
Esophageal intraluminal baseline impedance reflects the conductivity of the esophageal mucosa and may be an instrument for in vivo evaluation of mucosal integrity in children with gastroesophageal reflux disease (GERD). Laparoscopic antireflux surgery (LARS) is a well-established treatment option for children with proton pump inhibitory (PPI) therapy resistant GERD. The effect of LARS in children on baseline impedance has not been studied in detail. The aim of this study was to evaluate the effect of LARS on baseline impedance in children with GERD.
Methods
This is a prospective, multicenter, nationwide cohort study (
Dutch national trial registry
:
NTR2934
) including 25 patients [12 males, median age 6 (range 2–18) years] with PPI-resistant GERD scheduled to undergo LARS. Twenty-four hour multichannel intraluminal impedance pH monitoring (MII-pH monitoring) was performed before and 3 months after LARS. Baseline impedance was evaluated during consecutive 2-h intervals in the 24-h tracings.
Results
LARS reduced acid exposure time from 8.5 % (6.0–16.2 %) to 0.8 % (0.2–2.8 %),
p
< 0.001. Distal baseline impedance increased after LARS from 2445 Ω (1147–3277 Ω) to 3792 Ω (3087–4700 Ω),
p
< 0.001. Preoperative baseline impedance strongly correlated with acid exposure time (
r
−0.76,
p
< 0.001); however, no association between symptomatic outcome and baseline impedance was identified.
Conclusions
LARS significantly increased baseline impedance likely reflecting recovery of mucosal integrity. As the change in baseline impedance was not associated with the clinical outcome of LARS, other factors besides mucosal integrity may contribute to symptom perception in children with GERD.</description><subject>Abdominal Surgery</subject><subject>Adolescent</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Electric Impedance</subject><subject>Esophageal Mucosa - physiopathology</subject><subject>Esophageal pH Monitoring - methods</subject><subject>Esophagus</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Fundoplication - methods</subject><subject>Gastroenterology</subject><subject>Gastroesophageal reflux</subject><subject>Gastroesophageal Reflux - diagnosis</subject><subject>Gastroesophageal Reflux - physiopathology</subject><subject>Gastroesophageal Reflux - surgery</subject><subject>Gynecology</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Laparoscopy</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Proctology</subject><subject>Prospective Studies</subject><subject>Surgery</subject><subject>Treatment Outcome</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kU1rFTEUhoNY7LX6A9xIwI2bsfnOZCNIqR9Q6EbXIZN7Zm7KTDImM9WCP95c7rVWodmcwHnOez5ehF5R8o4Sos8LIUKJhlDVSE7q5wnaUMFZwxhtn6INMZw0TBtxip6XckMqbqh8hk6Zbokggm3Qr8uS5p0bwI14Wn0qNYa4wJDDcofDNOd0CwW7foGMRze7nIpPc_DYxSVk6Mf1Jy5rHiBXPGK_C-M2Q8Q_wrLDgytLTvC3xbFgGwq4Ai_QSe_GAi-P8Qx9-3j59eJzc3X96cvFh6vGS0GWhrfCcNNRJbVxvFfge8fqLrxjYssV0x0II3mnlfLK8K5CTDLwTiktmWb8DL0_6M5rN8HWQ1yyG-2cw-TynU0u2H8zMezskG6tFK1uja4Cb48COX1foSx2CsXDOLoIaS2WtlxKzgnfo2_-Q2_SmmNdz1JD6-OU80rRA-XrPUu9yv0wlNi9t_bgra3e2r23ltSa1w-3uK_4Y2YF2AEoNRWrIw9aP6r6G4cSsgQ</recordid><startdate>20170701</startdate><enddate>20170701</enddate><creator>Mauritz, Femke A.</creator><creator>Rinsma, Nicolaas F.</creator><creator>van Heurn, Ernest L. W.</creator><creator>Sloots, Cornelius E. J.</creator><creator>Siersema, Peter D.</creator><creator>Houwen, Roderick H. J.</creator><creator>van der Zee, David C.</creator><creator>Masclee, Ad A. M.</creator><creator>Conchillo, José M.</creator><creator>Van Herwaarden-Lindeboom, Maud Y. A.</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20170701</creationdate><title>Esophageal mucosal integrity improves after laparoscopic antireflux surgery in children with gastroesophageal reflux disease</title><author>Mauritz, Femke A. ; Rinsma, Nicolaas F. ; van Heurn, Ernest L. W. ; Sloots, Cornelius E. J. ; Siersema, Peter D. ; Houwen, Roderick H. J. ; van der Zee, David C. ; Masclee, Ad A. M. ; Conchillo, José M. ; Van Herwaarden-Lindeboom, Maud Y. A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c540t-384939b16579a3f6ecfa20043b24d3627be4953b766c693b9a3252eca66752723</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Abdominal Surgery</topic><topic>Adolescent</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Electric Impedance</topic><topic>Esophageal Mucosa - physiopathology</topic><topic>Esophageal pH Monitoring - methods</topic><topic>Esophagus</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Fundoplication - methods</topic><topic>Gastroenterology</topic><topic>Gastroesophageal reflux</topic><topic>Gastroesophageal Reflux - diagnosis</topic><topic>Gastroesophageal Reflux - physiopathology</topic><topic>Gastroesophageal Reflux - surgery</topic><topic>Gynecology</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Laparoscopy</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Proctology</topic><topic>Prospective Studies</topic><topic>Surgery</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mauritz, Femke A.</creatorcontrib><creatorcontrib>Rinsma, Nicolaas F.</creatorcontrib><creatorcontrib>van Heurn, Ernest L. W.</creatorcontrib><creatorcontrib>Sloots, Cornelius E. J.</creatorcontrib><creatorcontrib>Siersema, Peter D.</creatorcontrib><creatorcontrib>Houwen, Roderick H. J.</creatorcontrib><creatorcontrib>van der Zee, David C.</creatorcontrib><creatorcontrib>Masclee, Ad A. M.</creatorcontrib><creatorcontrib>Conchillo, José M.</creatorcontrib><creatorcontrib>Van Herwaarden-Lindeboom, Maud Y. A.</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mauritz, Femke A.</au><au>Rinsma, Nicolaas F.</au><au>van Heurn, Ernest L. W.</au><au>Sloots, Cornelius E. J.</au><au>Siersema, Peter D.</au><au>Houwen, Roderick H. J.</au><au>van der Zee, David C.</au><au>Masclee, Ad A. M.</au><au>Conchillo, José M.</au><au>Van Herwaarden-Lindeboom, Maud Y. A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Esophageal mucosal integrity improves after laparoscopic antireflux surgery in children with gastroesophageal reflux disease</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2017-07-01</date><risdate>2017</risdate><volume>31</volume><issue>7</issue><spage>2910</spage><epage>2917</epage><pages>2910-2917</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><abstract>Background
Esophageal intraluminal baseline impedance reflects the conductivity of the esophageal mucosa and may be an instrument for in vivo evaluation of mucosal integrity in children with gastroesophageal reflux disease (GERD). Laparoscopic antireflux surgery (LARS) is a well-established treatment option for children with proton pump inhibitory (PPI) therapy resistant GERD. The effect of LARS in children on baseline impedance has not been studied in detail. The aim of this study was to evaluate the effect of LARS on baseline impedance in children with GERD.
Methods
This is a prospective, multicenter, nationwide cohort study (
Dutch national trial registry
:
NTR2934
) including 25 patients [12 males, median age 6 (range 2–18) years] with PPI-resistant GERD scheduled to undergo LARS. Twenty-four hour multichannel intraluminal impedance pH monitoring (MII-pH monitoring) was performed before and 3 months after LARS. Baseline impedance was evaluated during consecutive 2-h intervals in the 24-h tracings.
Results
LARS reduced acid exposure time from 8.5 % (6.0–16.2 %) to 0.8 % (0.2–2.8 %),
p
< 0.001. Distal baseline impedance increased after LARS from 2445 Ω (1147–3277 Ω) to 3792 Ω (3087–4700 Ω),
p
< 0.001. Preoperative baseline impedance strongly correlated with acid exposure time (
r
−0.76,
p
< 0.001); however, no association between symptomatic outcome and baseline impedance was identified.
Conclusions
LARS significantly increased baseline impedance likely reflecting recovery of mucosal integrity. As the change in baseline impedance was not associated with the clinical outcome of LARS, other factors besides mucosal integrity may contribute to symptom perception in children with GERD.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>27804042</pmid><doi>10.1007/s00464-016-5304-0</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
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| ispartof | Surgical endoscopy, 2017-07, Vol.31 (7), p.2910-2917 |
| issn | 0930-2794 1432-2218 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5487897 |
| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Abdominal Surgery Adolescent Child Child, Preschool Electric Impedance Esophageal Mucosa - physiopathology Esophageal pH Monitoring - methods Esophagus Female Follow-Up Studies Fundoplication - methods Gastroenterology Gastroesophageal reflux Gastroesophageal Reflux - diagnosis Gastroesophageal Reflux - physiopathology Gastroesophageal Reflux - surgery Gynecology Hepatology Humans Laparoscopy Male Medicine Medicine & Public Health Proctology Prospective Studies Surgery Treatment Outcome |
| title | Esophageal mucosal integrity improves after laparoscopic antireflux surgery in children with gastroesophageal reflux disease |
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