PMID- 30052900
OWN - NLM
STAT- MEDLINE
DCOM- 20181211
LR  - 20181211
IS  - 1442-2050 (Electronic)
IS  - 1120-8694 (Linking)
VI  - 30
IP  - 7
DP  - 2017 Jul 1
TI  - Omission of preoperative esophageal manometry does not alter operative approach 
      or postoperative dysphagia following laparoscopic paraesophageal hernia repair.
PG  - 1-6
LID - 10.1093/dote/dox044 [doi]
AB  - Routine esophageal manometry for surgical planning before laparoscopic 
      paraesophageal hernia (PEH) has been advocated in an effort to reduce the 
      likelihood of postoperative dysphagia. The purpose of this study is to 
      investigate whether omitting routine preoperative esophageal manometry is 
      associated with a change in the type of fundoplication performed and with an 
      increase in the incidence of postoperative dysphagia. A retrospective cohort 
      study of consecutive patients with and without preoperative esophageal manometry 
      undergoing PEH repair was performed between January 2011 and July 2014 at an 
      academic medical center. Demographic and outcome data were collected in a 
      prospective database. The primary outcome measures were the type of 
      fundoplication performed and postoperative disease-specific quality-of-life 
      (GERD-HRQL) dysphagia score. Secondary outcome measures were total GERD-HRQL 
      score, proton pump inhibitor (PPI) use, and requirement for endoscopic dilation. 
      One hundred twenty-five patients underwent laparoscopic PEH repair. Forty-seven 
      (37%) patients had preoperative manometry and 79 (63%) did not. Patients who did 
      not have manometry were older (67.9 +/- 14.3 vs. 61.7 +/- 13.5, P = 0.02), but the 
      groups did not differ in terms of BMI, gender, PPI use, baseline GERD-HRQL 
      dysphagia score, or baseline total GERD-HRQL score. Sixty-nine (87%) patients 
      without manometry and 43 (93%) patients with manometry underwent a complete 
      fundoplication (P = 0.55). At a median follow-up of 16 (4-44) months, the median 
      GERD-HRQL dysphagia scores (0(0-1) vs. 0(0-1); P = 0.66) and total GERD-HRQL 
      scores (3(1-8) vs. 4(0-8); P = 0.72) were equivalent between the groups. 
      Equivalent proportion of patients without and with preoperative manometry used 
      PPI (9% vs. 21%; P = 0.06) and required endoscopic dilation (6% vs. 6%; P = 0.99) 
      in the postoperative period. Omission of routine preoperative manometry prior to 
      laparoscopic PEH repair is not associated with a change in the type of 
      fundoplication performed, an increased incidence of postoperative dysphagia, or 
      an increased requirement for postoperative endoscopic dilation.
FAU - Zevin, B
AU  - Zevin B
AD  - Department of Surgery, Queen's University, Kingston, Ontario, Canada.
AD  - Department of Surgery, The Ohio State University, Columbus, Ohio, USA.
FAU - Jones, E L
AU  - Jones EL
AD  - Department of Surgery, University of Colorado, Denver, Colorado, USA.
FAU - Martin Del Campo, S E
AU  - Martin Del Campo SE
AD  - Department of Surgery, The Ohio State University, Columbus, Ohio, USA.
FAU - Perry, K A
AU  - Perry KA
AD  - Department of Surgery, The Ohio State University, Columbus, Ohio, USA.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Dis Esophagus
JT  - Diseases of the esophagus : official journal of the International Society for 
      Diseases of the Esophagus
JID - 8809160
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Deglutition Disorders/*etiology
MH  - Dilatation
MH  - Esophagus/physiopathology
MH  - Female
MH  - Follow-Up Studies
MH  - Fundoplication/adverse effects/*methods
MH  - Gastroesophageal Reflux/etiology
MH  - Hernia, Hiatal/complications/*physiopathology/*surgery
MH  - Humans
MH  - Male
MH  - *Manometry
MH  - Middle Aged
MH  - Postoperative Complications/etiology
MH  - Preoperative Period
MH  - Proton Pump Inhibitors/therapeutic use
MH  - *Quality of Life
MH  - Retrospective Studies
MH  - Surveys and Questionnaires
EDAT- 2018/07/28 06:00
MHDA- 2018/12/12 06:00
CRDT- 2018/07/28 06:00
PHST- 2016/10/17 00:00 [received]
PHST- 2017/04/05 00:00 [accepted]
PHST- 2018/07/28 06:00 [entrez]
PHST- 2018/07/28 06:00 [pubmed]
PHST- 2018/12/12 06:00 [medline]
AID - 3835414 [pii]
AID - 10.1093/dote/dox044 [doi]
PST - ppublish
SO  - Dis Esophagus. 2017 Jul 1;30(7):1-6. doi: 10.1093/dote/dox044.