Akyüz Filiz, Arici Serpil, Ermiş Fatih, Mungan Zeynel
Department of Gastroenterohepatology, Istanbul University, Istanbul School of Medicine, Istanbul.
Turk J Gastroenterol. 2009 Dec;20(4):261-5. doi: 10.4318/tjg.2009.0023.
BACKGROUND/AIMS: The necessity of manometric evaluation before fundoplication in patients with gastroesophageal reflux disease is still a matter of debate. However, misdiagnosis can be responsible for postoperative problems. We aimed to evaluate the necessities of manometry and pH-metry before fundoplication in order to prevent possible complications after surgery.
Between 1997 and 2004, 259 consecutive patients who referred to our laboratory with a diagnosis of gastroesophageal reflux disease and request for manometric test before surgery were evaluated retrospectively. Manometric analysis was performed in all patients and 24-hour ambulatory pH-metry in 91 of them.
The mean age of the patients was 42.6+/-13 years and 51% were female. While 102 (39.4%) of the patients had normal esophageal motility, 122 (47.1%) had gastroesophageal reflux-related dysmotility (22% with ineffective esophageal motility, 25.1% with hypotensive lower esophageal sphincter). Primary esophageal motility disorders were detected in 29 (11.2%) patients (4 achalasia, 24 uncoordinated contractions and 1 nutcracker esophagus). Six patients had secondary dysmotility caused by scleroderma. Pathologic reflux was detected in 54 (59.3%) patients in whom pH-metry was performed.
Our results support that manometry and pH-metry must be performed before surgery in gastroesophageal reflux disease.
背景/目的：胃食管反流病患者在进行胃底折叠术之前进行测压评估的必要性仍存在争议。然而，误诊可能导致术后问题。我们旨在评估胃底折叠术之前进行测压和pH值测定的必要性，以预防手术后可能出现的并发症。
回顾性评估1997年至2004年间连续259例因诊断为胃食管反流病并要求在手术前进行测压检查而转诊至我们实验室的患者。对所有患者进行测压分析，其中91例患者进行了24小时动态pH值测定。
患者的平均年龄为42.6±13岁，51%为女性。102例（39.4%）患者食管动力正常，122例（47.1%）患者存在胃食管反流相关的动力障碍（22%为食管动力无效，25.1%为食管下括约肌压力降低）。29例（11.2%）患者检测到原发性食管动力障碍（4例贲门失弛缓症，24例不协调收缩，1例胡桃夹食管）。6例患者因硬皮病导致继发性动力障碍。在进行pH值测定的54例（59.3%）患者中检测到病理性反流。
我们的结果支持在胃食管反流病手术前必须进行测压和pH值测定。
