Gatzinsky Vladimir, Andersson Olof, Eriksson Anders, Jönsson Linus, Abrahamsson Kate, Sillén Ulla
Department of Pediatric Surgery, The Queen Silvia Children's Hospital, Gothenburg, Sweden.
Department of Otorhinolaryngology, Head and Neck Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
Eur J Pediatr Surg. 2016 Apr;26(2):172-9. doi: 10.1055/s-0034-1544049. Epub 2015 Feb 2.
Gastroesophageal reflux (GER) and dysphagia are common following repaired esophageal atresia (EA). The risk of esophagitis and Barrett esophagus is increased compared with the general population. As yet, the causes are not fully explained.
The aim of this study was to investigate how GER, measured by pH multichannel intraluminal impedance (pH-MII), is correlated to the esophageal symptoms and histological findings.
Twenty-nine adult subjects operated for EA in Gothenburg from 1968 to 1983 were evaluated with pH-MII, manometry, and gastroscopy.
pH-MII was performed in 15, manometry in 19, and gastroscopy in 24 subjects. Eleven subjects displayed pathological reflux parameters of any kind, mainly nonacid reflux (10/15). Dysphagia correlated to the number of weakly acidic reflux episodes. Lower esophageal sphincter (LES) incompetence, which correlated to a pathological number of acid reflux episodes (p = 0.012), was noted in 21/24 subjects, but the majority had a normal resting pressure. Esophagitis was present in 14/24, two of whom had Barrett esophagus. Histological changes correlated to the reflux index and the number of weakly acidic reflux episodes (p = 0.028 and 0.040) and tended to correlate to dysphagia (p = 0.052).
pH-MII adds further information when it comes to explaining what causes symptoms and esophageal histological changes in adults operated for EA.
食管闭锁（EA）修复术后，胃食管反流（GER）和吞咽困难很常见。与普通人群相比，食管炎和巴雷特食管的风险增加。迄今为止，其病因尚未完全明确。
本研究旨在探讨通过多通道腔内pH阻抗监测（pH-MII）测量的GER与食管症状和组织学结果之间的相关性。
对1968年至1983年在哥德堡接受EA手术的29名成年受试者进行了pH-MII、测压和胃镜检查。
15名受试者进行了pH-MII检查，19名进行了测压，24名进行了胃镜检查。11名受试者出现了任何类型的病理性反流参数，主要是非酸性反流（10/15）。吞咽困难与弱酸性反流发作次数相关。21/24名受试者存在食管下括约肌（LES）功能不全，这与酸性反流发作次数的病理性增加相关（p = 0.012），但大多数人的静息压力正常。24名受试者中有14名患有食管炎，其中2名患有巴雷特食管。组织学变化与反流指数和弱酸性反流发作次数相关（p = 0.028和0.040），并倾向于与吞咽困难相关（p = 0.052）。
在解释EA手术后成人的症状和食管组织学变化的原因时，pH-MII提供了更多信息。
