Esophageal mucosal integrity improves after laparoscopic antireflux surgery in children with gastroesophageal reflux disease

Femke A. Mauritz; Nicolaas F. Rinsma; Ernest L. W. van Heurn; Cornelius E. J. Sloots; Peter D. Siersema; Roderick H. J. Houwen; David C. van der Zee; Ad A. M. Masclee; Jose M. Conchillo; Maud Y. A. van Herwaarden-Lindeboom

doi:10.1007/s00464-016-5304-0

Esophageal mucosal integrity improves after laparoscopic antireflux surgery in children with gastroesophageal reflux disease

Femke A. Mauritz^*, Nicolaas F. Rinsma, Ernest L. W. van Heurn, Cornelius E. J. Sloots, Peter D. Siersema, Roderick H. J. Houwen, David C. van der Zee, Ad A. M. Masclee, Jose M. Conchillo, Maud Y. A. van Herwaarden-Lindeboom

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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 Omega (1147-3277 Omega) to 3792 Omega (3087-4700 Omega), 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.

Original language	English
Pages (from-to)	2910-2917
Number of pages	8
Journal	Surgical endoscopy and other interventional techniques
Volume	31
Issue number	7
DOIs	https://doi.org/10.1007/s00464-016-5304-0
Publication status	Published - Jul 2017

Keywords

Gastroesophageal reflux disease
Laparoscopic fundoplication
Baseline impedance
Pediatrics
BASE-LINE IMPEDANCE
MULTICHANNEL INTRALUMINAL IMPEDANCE
PARTIAL FUNDOPLICATION
ACID EXPOSURE
GERD PATIENTS
GAS REFLUX
INFANTS
HEARTBURN
PATTERNS
AGE

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Cite this

Mauritz, F. A., Rinsma, N. F., van Heurn, E. L. W., Sloots, C. E. J., Siersema, P. D., Houwen, R. H. J., van der Zee, D. C., Masclee, A. A. M., Conchillo, J. M., & van Herwaarden-Lindeboom, M. Y. A. (2017). Esophageal mucosal integrity improves after laparoscopic antireflux surgery in children with gastroesophageal reflux disease. Surgical endoscopy and other interventional techniques, 31(7), 2910-2917. https://doi.org/10.1007/s00464-016-5304-0

@article{76941cdfceaf4133aa34817cd42e9d75,

title = "Esophageal mucosal integrity improves after laparoscopic antireflux surgery in children with gastroesophageal reflux disease",

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 Omega (1147-3277 Omega) to 3792 Omega (3087-4700 Omega), 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.",

keywords = "Gastroesophageal reflux disease, Laparoscopic fundoplication, Baseline impedance, Pediatrics, BASE-LINE IMPEDANCE, MULTICHANNEL INTRALUMINAL IMPEDANCE, PARTIAL FUNDOPLICATION, ACID EXPOSURE, GERD PATIENTS, GAS REFLUX, INFANTS, HEARTBURN, PATTERNS, AGE",

author = "Mauritz, {Femke A.} and Rinsma, {Nicolaas F.} and {van Heurn}, {Ernest L. W.} and Sloots, {Cornelius E. J.} and Siersema, {Peter D.} and Houwen, {Roderick H. J.} and {van der Zee}, {David C.} and Masclee, {Ad A. M.} and Conchillo, {Jose M.} and {van Herwaarden-Lindeboom}, {Maud Y. A.}",

year = "2017",

month = jul,

doi = "10.1007/s00464-016-5304-0",

language = "English",

volume = "31",

pages = "2910--2917",

journal = "Surgical endoscopy and other interventional techniques",

issn = "0930-2794",

publisher = "Springer, Cham",

number = "7",

}

Mauritz, FA, Rinsma, NF, van Heurn, ELW, Sloots, CEJ, Siersema, PD, Houwen, RHJ, van der Zee, DC, Masclee, AAM, Conchillo, JM & van Herwaarden-Lindeboom, MYA 2017, 'Esophageal mucosal integrity improves after laparoscopic antireflux surgery in children with gastroesophageal reflux disease', Surgical endoscopy and other interventional techniques, vol. 31, no. 7, pp. 2910-2917. https://doi.org/10.1007/s00464-016-5304-0

Esophageal mucosal integrity improves after laparoscopic antireflux surgery in children with gastroesophageal reflux disease. / Mauritz, Femke A.; Rinsma, Nicolaas F.; van Heurn, Ernest L. W. et al.
In: Surgical endoscopy and other interventional techniques, Vol. 31, No. 7, 07.2017, p. 2910-2917.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Esophageal mucosal integrity improves after laparoscopic antireflux surgery in children with gastroesophageal reflux disease

AU - Mauritz, Femke A.

AU - Rinsma, Nicolaas F.

AU - van Heurn, Ernest L. W.

AU - Sloots, Cornelius E. J.

AU - Siersema, Peter D.

AU - Houwen, Roderick H. J.

AU - van der Zee, David C.

AU - Masclee, Ad A. M.

AU - Conchillo, Jose M.

AU - van Herwaarden-Lindeboom, Maud Y. A.

PY - 2017/7

Y1 - 2017/7

N2 - 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 Omega (1147-3277 Omega) to 3792 Omega (3087-4700 Omega), 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.

AB - 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 Omega (1147-3277 Omega) to 3792 Omega (3087-4700 Omega), 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.

KW - Gastroesophageal reflux disease

KW - Laparoscopic fundoplication

KW - Baseline impedance

KW - Pediatrics

KW - BASE-LINE IMPEDANCE

KW - MULTICHANNEL INTRALUMINAL IMPEDANCE

KW - PARTIAL FUNDOPLICATION

KW - ACID EXPOSURE

KW - GERD PATIENTS

KW - GAS REFLUX

KW - INFANTS

KW - HEARTBURN

KW - PATTERNS

KW - AGE

U2 - 10.1007/s00464-016-5304-0

DO - 10.1007/s00464-016-5304-0

M3 - Article

C2 - 27804042

SN - 0930-2794

VL - 31

SP - 2910

EP - 2917

JO - Surgical endoscopy and other interventional techniques

JF - Surgical endoscopy and other interventional techniques

IS - 7

ER -