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Effectiveness of esophageal manometry in predicting the outcome of children with primary GER after floppy Nissen-Rossetti wrap

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An Erratum to this article was published on 28 December 2005

Abstract

Background

Surgical treatment of gastroesophageal reflux (GER) can result in many postoperative problems because of an incorrect indication or an unsuitable fundoplication. Many preoperative tests have been suggested to perform a “tailored fundoplication,” but there is no clear evidence as to which is the best. The aim of our study was to define the effectiveness of esophageal manometry in predicting the outcome of children who need fundoplication because of refractory primary gastroesophageal reflux.

Methods

Thirty-two children were included in the study. Patients with gastroenterologic and respiratory symptoms numbered 10 (31%) and 22 (69%), respectively. The preoperative motility pattern was (1) inappropriate relaxations alone in nine patients (28%) and associated with esophageal body dysmotility in one patients (3%); (2) low-pressure lower esophageal sphincter (LES), alone in 13 patients (41%) and associated with body dysmotility in eight (25%). Motility pattern of the esophageal body was abnormal in nine children. Manometric anomalies were absent only in one case.

Results

Low pressure of the LES associated with atypical esophageal motility disorders was significantly higher in the gastroenterological group and in the older patients. Low pressure of the LES associated with good esophageal activity was significantly higher in the respiratory group and in the patients younger than 24 months. There was no correlation between motility pattern and outcome, and no statistically significant differences were found between pressure values at the different levels and symptoms, outcome, and age groups.

Conclusions

Esophageal manometry is not mandatory to predict the outcome of patients undergoing laparoscopic Nissen-Rossetti fundoplication for refractory primary GER treatment.

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Acknowledgments

We thank Anna Capurro for her English language revision. We thank Francesca Roncallo for administrative support and computerized data collection during the study period.

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Authors and Affiliations

  1. Department of Pediatric Surgery, Giannina Gaslini Research Institute, University of Genova, Largo G. Gaslini, 5, Genova, 16100, italy

    G. Mattioli, V. Gentilino, E. Caponcelli, F. Martino, M. Castagnetti, A. PiniPrato & V. Jasonni

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  1. G. Mattioli
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  2. V. Gentilino
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  3. E. Caponcelli
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  4. F. Martino
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  5. M. Castagnetti
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  6. A. PiniPrato
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  7. V. Jasonni
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Corresponding author

Correspondence to G. Mattioli.

Additional information

An erratum to this article is available at http://dx.doi.org/10.1007/s00464-005-3003-3.

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Mattioli, G., Gentilino, V., Caponcelli, E. et al. Effectiveness of esophageal manometry in predicting the outcome of children with primary GER after floppy Nissen-Rossetti wrap. Surg Endosc 18, 1504–1508 (2004). https://doi.org/10.1007/s00464-003-9307-2

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  • DOI: https://doi.org/10.1007/s00464-003-9307-2

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