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首页> 外文期刊>Surgical Endoscopy >Prospective study examining the impact of multichannel intraluminal impedance on antireflux surgery.
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Prospective study examining the impact of multichannel intraluminal impedance on antireflux surgery.

机译：前瞻性研究检查了多通道腔内阻抗对抗反流手术的影响。

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BACKGROUND: Reflux monitoring using combined multichannel intraluminal impedance (MII) and pH-metry increases the sensitivity for identifying gastroesophageal reflux episodes. The likelihood of a positive symptom index (SI) for patients with reflux disease (gastroesophageal reflux disease [GERD] or nonerosive reflux disease [NERD]) receiving proton pump inhibitor (PPI) treatment has been used to select candidates for antireflux surgery. Little is known about the advantages of MII-pH monitoring compared with pH monitoring alone for evaluating GERD/NERD patients off PPI treatment considered as candidates for antireflux surgery or for assessing changes in MII-pH-detected reflux episodes after antireflux surgery. This study aimed to determine the additional value of MII over pH-metry alone for patients off PPI treatment before and after antireflux surgery. METHODS: For this study 12 patients (4 women and 8 men; mean age, 45 years; range, 27-74 years) were evaluated using ambulatory MII-pH monitoring beforeand 3 months after mesh-augmented hiatoplasty. Reflux events were identified by MII-pH (A) and pH-metry (B) as patients recorded symptoms on a data logger. For each symptom, a symptom index was calculated for reflux events identified by MII-pH and by pH-monitoring alone. RESULTS: Preoperatively, MII-pH monitoring identified 71.9 +/- 8.4 reflux episodes, whereas pH monitoring identified only 51.0 +/- 7.8 (p < 0.05). Postoperatively, MII-pH monitoring identified 35.5 +/- 6.6 reflux episodes, whereas pH monitoring identified only 19.6 +/- 4.7 (p < 0.05). The pre- and postoperative symptom index for MII-pH monitoring was higher than pH monitoring (preoperative 91.7% vs 25%, p = 0.006; postoperative 50% vs 16.7%, p = 0.012). CONCLUSION: Combined MII-pH-metry improves the pre- and postoperative assessment of GERD patients off PPI and results in a higher symptom-reflux association.
机译：背景：使用多通道腔内阻抗（MII）和pH值测量相结合的回流监测可提高识别胃食管反流发作的敏感性。接受质子泵抑制剂（PPI）治疗的反流疾病（胃食管反流疾病[GERD]或非侵蚀性反流疾病[NERD]）患者的症状指数（SI）呈阳性的可能性已被用于选择抗反流手术的候选人。关于MII-pH监测与单独使用pH监测相比，对于评估被认为是抗反流手术候选者的PPI治疗后的GERD / NERD患者，或用于评估抗反流手术后MII-pH检测到的反流发作变化的优势，知之甚少。这项研究的目的是确定抗回流手术之前和之后停用PPI治疗的患者，仅凭pH值测定得出MII的附加价值。方法：在本研究中，在网状硬膜成形术前和术后3个月采用动态MII-pH监测对12例患者（4名女性和8名男性;平均年龄为45岁;范围为27-74岁）进行了评估。当患者在数据记录仪上记录症状时，通过MII-pH（A）和pH-metric（B）识别出反流事件。对于每种症状，计算通过MII-pH和仅通过pH监测确定的反流事件的症状指数。结果：术前，MII-pH监测发现71.9 +/- 8.4反流发作，而pH监测仅发现51.0 +/- 7.8（p <0.05）。术后，MII-pH监测发现35.5 +/- 6.6反流发作，而pH监测仅发现19.6 +/- 4.7（p <0.05）。 MII-pH监测的术前和术后症状指数高于pH监测（术前91.7％vs 25％，p = 0.006;术后50％vs 16.7％，p = 0.012）。结论：MII-pH联合测定可改善GERD患者PPI的术前和术后评估，并导致更高的症状与反流关联。

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