Page 86 - Effects and Efficacy of (Laparoscopic) Gastrostomy Placement in Children - Josephine Franken

patients without preoperative GER developed pathological GER after operation, and in four patients GER dissolved. No patients showed a deterioration of GER that required fundoplication during follow-up.
subgroup analysis: patients with preoperative pathological GeR versus no pathological GeR
In 18 out of 25 patients pathological GER (72%) was found with MII-pH analysis. MII-pH analysis showed that all pH parameters in the 18 patients seemed to decrease and impedance parameters seemed to increase, although none of these changes were statistically significant (Table 3A). The complete table with all MII-pH parameters in these patients is depicted in Appendix 2a.
Table 3A. 24-hour Mii-pH monitoring: patients with preoperative pathological reflux (n=18).
Preoperative median (iQR)
Postoperative median (iQR)
Mean difference (95% Ci)1
i. pH analysis
Total acid exposure per 24 hour (%)
10.8 (5.7 – 23.1)
8.8 (3.5 – 21.7)
-1.1 (-8.3 – 6.1)
number of reflux episodes (pH<4)
59.9 (49.8 – 78.3)
50.0 (31.5 – 72.7)
-16.1 (-49.8 – 17.6)
number of episodes > 5 min.
5.4 (1.5 – 25.4)
4.1 (1.2 – 11.2)
-2.0 (-5.4 – 1.4)
ii. impedance analysis
Total reflux episodes per 24 hour
73.1 (49.4 – 83.5)
75.5 (47.6 – 127.7)
14.8 (-14.1 – 43.7)
Acid
53.8 (43.3 – 70.2)
54.5 (30.6 – 74.1)
5.4 (-20.0 – 30.8)
Weakly acidic
18.1 (8.8 – 24.7)
25.1 (8.6 – 35.0)
8.0 (-1.5 – 17.6)
Legend: 1. Paired samples t-test. BCT = bolus clearance time; GER = gastroesophageal reflux; IQR = interquartile range; NA = not applicable; 95% CI = 95% confidence interval.
In 7 out of 25 patients MII-pH metry showed no pathological GER (38%). Four out of these 7 patients (57.1%) newly developed pathological GER after operation.
MII-pH analysis showed that, total acid exposure in these 7 patients increased slightly after operation with a mean difference of 1.9% (0.1 – 3.8; Table 3B). Similarly, the number of reflux episodes lasting longer than 5 minutes increased with a mean difference of 1.3 (0.2 – 2.4). The complete table with all MII-pH parameters in these patients is depicted in Appendix 2b.
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