Abstract

MIGUEL, Pablo Roberto; ROSA, André Luiz Moreira da; REUSCH, Marcus  and  CARLOS, José Roberto Couto B.. Esophageal manometry and 24 hour ph monitoring to evaluate laparoscopic lind fundoplication in gastroesophageal reflux disease. Rev. Col. Bras. Cir. [online]. 1998, vol.25, n.4, pp. 241-245. ISSN 0100-6991.  http://dx.doi.org/10.1590/S0100-69911998000400005.

The recent introduction and widespread use of laparoscopic and thoracoscopic techniques has given a new dimension to esophageal functional surgery. A successful result depends on the documentation of esophageal disease as the cause of symptoms, the understanding of the cause of esophageal dysfunction, and the identification of patients who should have surgical treatment. This paper is a retrospective study developed in patients underwent Lind operation for gastroesophageal reflux. The study wants to establish the value of rotine use of esophageal manometry and 24 hour pH monitoring for selection and evaluation. Forty-one patients (68.3%) had mechanically defective lower esophageal sphincter. The preoperative pressure was 9.2 mmHg and postoperative 15.2 mmHg. The general increase was 6.0 mmHg, the increase in defective sphincters was 8.8 mmHg and in normal sphincters was 4.3. We found some diminished peristalsis of esophageal body in 14 patients (23.3%), and this group had four patients (28.5%) with improved peristalsis after surgery. Abnormal acid reflux was detected in 51 cases (85.0%) by pH monitoring. The preoperative DeMeester score was 31.4, decreasing to 3.2 at postoperative period. Esophageal manometry and 24 hour pH monitoring are efficient methods to detect and measure the functional modifications established with an antireflux procedure.

Keywords : Gastroesophageal reflux; Antireflux surgery; Digestive motility.