Pastore Ricardo, Crema Eduardo, Silveira Mariana de Carvalho, Presoto Adriana Ferreira, Herbella Fernando Augusto Mardiros, Del Grande José Carlos
Universidade Federal de São Paulo, São Paulo, SP.
Arq Gastroenterol. 2006 Apr-Jun;43(2):112-6. doi: 10.1590/s0004-28032006000200010.
The electromanometry and 24-hour esophageal pHmetry has been proposed as objective method in postoperative evaluation of antireflux surgery.
Prospective evaluation of the results of cruroplasty and total fundoplication in the treatment of non-complicated gastroesophageal reflux disease based on comparative results of pre and post operative manometry and pHmetry findings.
Fifty-nine consecutive individuals with typical symptoms of gastroesophageal reflux disease were prospectively studied. All patients were submitted to a laparoscopic short floppy Nissen fundoplication between March, 2002 and August, 2003. All patients were submitted pre and postoperatively (3 months) to upper digestive endoscopy, manometry and pHmetry 24 hours.
Eighteen (30.5%) patients were male and 41 (69.5%) female, their average age was 43.8 years. There were differences comparing the pre and post operative period in the manometrical findings in the following items: localization of the lower esophageal sphincter (41.2 cm and 42.3 cm). Extension o f the lower esophageal sphincter preoperative (2.0 cm and 2.5 cm), resting pressure of the lower esophageal sphincter (15.0 mm Hg and 21.5 mm Hg), and pressure of the esophageal body (78.0 mm Hg and 70.0 mm Hg). There were differences comparing the pre and post operative period in the pHmetrical findings in the following items: total number of acid refluxes (68.0 and 3.0), total number of acid refluxes more than 5 minutes (2.0 and 0.0), acid reflux more than 5 minutes in supine position (1.0 and 0.0), acid reflux more than 5 minutes in upright position (0.0 and 0.0), acidification period (5.5 and 0.1 min), DeMeester score (33.0 and 0.8).
The esophageal manometry and pHmetry findings were improved in the post operative period with statistical significance when compared to the pre operative period. The exams were considered efficient in the evaluation of the surgical procedure.
食管压力测定法和24小时食管pH监测法已被提议作为抗反流手术术后评估的客观方法。
基于术前和术后测压及pH监测结果的对比，对胃底折叠术和全胃底折叠术治疗非复杂性胃食管反流病的结果进行前瞻性评估。
对59例有胃食管反流病典型症状的连续患者进行前瞻性研究。2002年3月至2003年8月期间，所有患者均接受了腹腔镜下短松驰Nissen胃底折叠术。所有患者在术前和术后（3个月）均接受了上消化道内镜检查、测压和24小时pH监测。
18例（30.5%）患者为男性，41例（69.5%）为女性，平均年龄为43.8岁。在测压结果方面，术前和术后在以下项目上存在差异：食管下括约肌的定位（41.2厘米和42.3厘米）。食管下括约肌术前的长度（2.0厘米和2.5厘米）、食管下括约肌的静息压力（15.0毫米汞柱和21.5毫米汞柱）以及食管体部压力（78.0毫米汞柱和70.0毫米汞柱）。在pH监测结果方面，术前和术后在以下项目上存在差异：酸反流总数（68.0和3.0）、持续超过5分钟的酸反流总数（2.0和0.0）、仰卧位时持续超过5分钟的酸反流（1.0和0.0）、直立位时持续超过5分钟的酸反流（0.0和0.0）、酸化期（5.5和0.1分钟）、DeMeester评分（33.0和0.8）。
与术前相比，术后食管测压和pH监测结果有统计学意义的改善。这些检查被认为在评估手术效果方面是有效的。
