Page 84 - Effects and Efficacy of (Laparoscopic) Gastrostomy Placement in Children - Josephine Franken

To analyze differences between participants and non-participants in the MII-pH study, analysis of GER symptoms and nutritional status was performed for both patient groups, shown in Appendix 1.
symptom analysis according to GsQ
GER symptoms, reported by the GSQ, were present in a comparable number of patients before GP (11 / 25 = 44%) and after GP (10 / 25 = 40%; McNemar p = 0.73).
Table 1. Patient characteristics.
Responders in Mii-pH analysis (n=25)
non-responders (only symptom analysis; n=25)
Difference
n (%) or median (iQR)
n (%) or median (iQR)
Male gender
17 (68%)
12 (48%)
p = 0.25 1
Age in years at operation
3.2 (1.2 – 5.6)
4.7 (1.5 – 8.7)
p = 0.10 2
Weight-for-height percentile
30 (1.0 – 85.0)
14 (0.6 – 84.0)
p = 0.16 2
Height-for-age percentile
2 (0.6 – 16.0)
8.0 (0.6 – 30.0)
p = 0.33 2
Main underlying pathology
Neurologic impairment
20 (80%)
16 (64%)
p = 0.35
Cystic fibrosis
1 (4%)
3 (12%)
NA
Undiagnosed FTT
1 (4%)
1 (4%)
NA
Short bowel disease
1 (4%)
1 (4%)
NA
Pulmonary disease
1 (4%)
0
NA
Cardiac disease
0
1 (4%)
NA
Metabolic disorder
1 (4%)
0
NA
Legend: 1 Fisher’s exact test. 2 Independent samples t-test
CF: Cystic fibrosis; FTT: failure to thrive; IQR: interquartile range; NA: not applicable
24-hour Mii-pH monitoring
Results of the 25 patients with 24-hour MII-pH monitoring are summarized in Table 2. Analysis of the pH-metry data showed that none of the parameters significantly changed after GP. The median total acid exposure remained unchanged after operation: 6.2% (3.0 – 18.1) to 6.1% (2.6 – 14.9).
Almost all reflux parameters decreased, but this change was not statistically significant. Conversely, the parameters on impedance analysis all increased, although again none of the parameters changed significantly. There were no changes in liquid reflux and mixed liquid-gas reflux. Similarly, acid reflux and weakly acid reflux did not differ. Neither the proximal extend of the reflux boluses nor the bolus clearance time in the distal esophagus (Z6) changed after GP.
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