Page 87 - Effects and Efficacy of (Laparoscopic) Gastrostomy Placement in Children - Josephine Franken

Table 3B. 24-hour Mii-pH monitoring: patients without preoperative pathological reflux (n=7).
Chapter 5
Preoperative median (iQR)
Postoperative median (iQR)
Mean difference (95% Ci)1
i. pH analysis
Total acid exposure per 24 hour (%)
1.3 (0.6 – 2.6)
2.5 (1.6 – 7.5)
1.9 (0.1 – 3.8)
number of reflux episodes (pH<4)
11.6 (6.1 – 41.2)
17.0 (8.5 – 19.2)
-7.0 (-26.2 – 12.2)
number of episodes > 5 min.
0.0 (0.0 – 1.2)
1.3 (1.1 – 2.2)
1.3 (0.2 – 2.4)
ii. impedance analysis
Total reflux episodes per 24 hour
31.6 (23.6 – 38.8)
25.6 (17.9 – 38.2)
-4.3 (-21.0 – 12.3)
Acid
18.2 (4.1 – 25.0)
10.2 (8.1 – 21.5)
-3.8 (-14.1 – 6.4)
Weakly acidic
13.5 (6.2 – 27.5)
7.9 (5.7 – 17.1)
-0.3 (-8.8 – 8.2)
Legend: 1. Paired samples t-test was used when differences were normally distributed. BCT = bolus clearance time; GER = gastroesophageal reflux; IQR = interquartile range; NA = not applicable; CI = confidence interval.
Predictors of increased acid exposure after GP
In multivariable regression analysis of increased acid exposure after GP, preoperative weight- for-height percentile was a negative predictor, with a predictive value (B) of -0.5 (95% CI -0.28 – -0.1), indicating that low preoperative weight-for-height predicts an increase in acid exposure after GP. Not predictive of acid exposure were age (B -0.1 (-2.0 – 0.9)) and NI (B -0.3 (-19.7 – 1.5)).
Gastric emptying in correlation to GeR
The preoperative gastric half-emptying time was correlated to both the preoperative total acid exposure (rs=0.43; p=0.04) and the number of reflux episodes (rs=0.46; p=0.03)(Table 4). After GP no correlation was found between postoperative gastric emptying and reflux parameters.
Table 4. Correlations between Mii-pH monitoring and gastric emptying (n=25).
Legend: 1. Calculated with preoperative reflux values. 2. Calculated with postoperative reflux values. 3. Calculated with increase in reflux values.
T1⁄2 = gastric half-emptying time converted to percentiles. rs = Spearman correlation coefficient.
Correlations
Preoperative T1⁄21
Postoperative T1⁄2 2
increase in T1⁄2 3
rs
p-value
rs
p-value
rs
p-value
Total acid exposure per 24 hour (%)
0.43
0.04
0.10
0.65
0.49
0.03
nr of reflux episodes
0.46
0.03
0.12
0.59
0.13
0.58
nr of episodes > 5 minutes
0.27
0.27
0.35
0.11
0.47
0.03
Longest reflux episode
0.23
0.30
0.21
0.35
0.28
0.23
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