PS01.007: THE ROLE OF HIGH RESOLUTION MANOMETRY AFTER TOUPET-FUNDOPLICATION: COMPARING THE RESULTS WITH THE SYMPTOMS REMAINED 6 MONTHS AFTER SURGERY

Abstract Background Fundoplication is a well accepted method in treatment of gastro-esophageal reflux disease. High Resolution Manometry (HRM) is essential in diagnosis of functional esophageal diseases. The aim of our study was to find the place and value of HRM after 6 months of Toupet-fundoplication, and find correlation in symptoms remained, if any. Methods In 2016–2017 98 Toupet-fundoplications were performed by single surgeon. Surgeries were after HRM, EGD and pre-operative reflux symptom questionnaire performed in our Esophageal Center. Six months after surgery EGD, HRM and post-operative symptom questionnaire was planned to manage in each patients. Results Until Feb/01/2018 74/98 patients were more than 6 months after their operation. 72/74 patients completed the questionnaire and the EGD as well. 28/72 patients absolved HRM also. 25/28 patients had no complains and pre-operative symptoms relieved completely requiring neither PPI nor H2 blockers. 2/28 patients had gastric emptying problems, and 1/28 had moderate reflux associated symptom. Compared to that 22/28 patients HRM verified abnormal values mostly in DCI, however these 22 patients were asymptomatic. It has to be mentioned that DCI was better pre-operatively than post-operatively in 12 out of 22 cases. Conclusion Post-operative HRM can qualify and describe the wrap objectively (its location and basic pressure) however the latest Chicago-criteria was not developed for after-surgery states. We can conclude that post-operative routine HRM can mislead the physician, has importance only in patients with significant complains. Disclosure All authors have declared no conflicts of interest.

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OC.05.5 ROLE OF HIGH RESOLUTION MANOMETRY FINDINGS AND OF GASTRO-ESOPHAGEAL REFLUX DISEASE IN PATIENTS WITH NON OBSTRUCTIVE DYSPHAGIA

Digestive and Liver Disease ◽

10.1016/s1590-8658(16)30054-8 ◽

2016 ◽

Vol 48 ◽

pp. e88-e89

Author(s):

M. Ribolsi ◽

D. Biasutto ◽

P. Balestrieri ◽

M. Cicala

Keyword(s):

High Resolution ◽

Reflux Disease ◽

Esophageal Reflux ◽

High Resolution Manometry

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Role of gastric emptying rate in duodeno-gastro-esophageal reflux (DGER) in man

Gastroenterology ◽

10.1016/s0016-5085(00)80879-3 ◽

2000 ◽

Vol 118 (4) ◽

pp. A1258

Author(s):

Gerardus H. Koek ◽

Anthon Lerut ◽

Daniel Sifrim ◽

Jozef Janssens ◽

Jan F. Tack

Keyword(s):

Gastric Emptying ◽

Esophageal Reflux ◽

Gastric Emptying Rate

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Backflow prevention mechanism of laparoscopic Toupet fundoplication using high-resolution manometry

Surgical Endoscopy ◽

10.1007/s00464-015-4532-z ◽

2015 ◽

Vol 30 (7) ◽

pp. 2703-2710 ◽

Cited By ~ 7

Author(s):

Masato Hoshino ◽

Nobuo Omura ◽

Fumiaki Yano ◽

Kazuto Tsuboi ◽

Se Ryung Yamamoto ◽

...

Keyword(s):

High Resolution ◽

Toupet Fundoplication ◽

High Resolution Manometry ◽

Laparoscopic Toupet Fundoplication

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High-Resolution Manometry and Assessment of Esophageal Reflux

Gastrointestinal Endoscopy ◽

10.1007/978-1-4939-2032-7_6 ◽

2015 ◽

pp. 107-126

Author(s):

Mary K. Rude ◽

C. Prakash Gyawali

Keyword(s):

High Resolution ◽

Esophageal Reflux ◽

High Resolution Manometry

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Role of high resolution manometry in the diagnostic and therapeutic approach of post fundoplication dysphagia

Gastroenterología y Hepatología (English Edition) ◽

10.1016/j.gastre.2019.01.023 ◽

2019 ◽

Vol 42 (8) ◽

pp. 488-489

Author(s):

Armando Peixoto ◽

Rui Morais ◽

Aitor Lanas-Gimeno ◽

Teresa Pérez-Fernandez ◽

Sergio Casabona-Francés ◽

...

Keyword(s):

High Resolution ◽

Therapeutic Approach ◽

High Resolution Manometry

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PS01.005: HIGH-RESOLUTION MANOMETRY GUIDING SURGICAL PROCEDURE FOR TREATMENT OF ACHALASIA OF THE ESOPHAGUS. LONG-TERM RESULTS OF A PROSPECTIVE STUDY

Diseases of the Esophagus ◽

10.1093/dote/doy089.ps01.005 ◽

2018 ◽

Vol 31 (Supplement_1) ◽

pp. 51-51

Author(s):

Tania Triantafyllou ◽

Georgia Doulami ◽

Charalampos Theodoropoulos ◽

Georgios Zografos ◽

Dimitrios Theodorou

Keyword(s):

High Resolution ◽

Prospective Study ◽

Conflicts Of Interest ◽

Long Term Results ◽

Type I ◽

Laparoscopic Myotomy ◽

Term Outcome ◽

Long Term Outcome ◽

High Resolution Manometry

Abstract Background Laparoscopic myotomy and fundoplication for the treatment of achalasia presents with 90% success rate. The intraoperative use of manometry during surgery has been previously introduced to improve the outcome. Recently, we presented our pilot study proposing the use of the HRM during surgery. The aim of this study is to evaluate the long-term outcome of the intraoperative use of High-Resolution Manometry (HRM) in achalasia patients. Methods In this prospective study, consecutive achalasia patients underwent laparoscopic myotomy and fundoplication along with real-time use of HRM. Eckardt scores (ES) and HRM results were collected before and after surgery. Results Twenty-three achalasia patients (22% Type I, 57% Type II, 22% Type III, according to Chicago Classification v3.0) with a mean age 48 years underwent calibrated and uneventful myotomy and fundoplication. Eleven myotomies were further extended, while sixteen fundoplications were intraoperatively modified, according to manometric findings. During postoperative follow-up, mean resting and residual pressures of the LES were significantly decreased after surgery (16,1 vs. 41,9, P = 0 and 9 vs. 28,7, P = 0, respectively). The ES was also diminished (1 vs. 7, P = 0). Conclusion The intraoperative use of HRM during laparoscopic myotomy and fundoplication for the treatment of achalasia of the esophagus is a safe, promising and efficient approach aiming to individualize both myotomy and fundoplication for each achalasia patient. Disclosure All authors have declared no conflicts of interest.

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