Duodenogastric Reflux Clinical Trial
Official title:
Study of Prognostic Factors for Long Term Results of Total Laparoscopic Fundoplication for Weakly Acidic or Mixed Reflux
After laparoscopic total fundoplication (LTF) 12-15% of patients have persistent reflux
symptoms and 20-25% develop gas-related symptoms. Reflux symptoms, gas bloating and
inability to belch occurring after surgery have been associated with mixed (acid and weakly
acid) (MR) or weakly acidic reflux (WAR). To date, few studies have evaluated functional
outcome after LTF in patients with MR or WAR, with the majority reporting only short-term
results.
It has been shown that delayed gastric emptying (DGE) might also be an important factor for
abdominal distension and adverse outcome after LTF.9,10 However, the correlation between
poor long-term outcome after LTF and DGE is controversial. In addition, the effect of DGE in
patients with MR or WAR is poorly investigated.
In the last years the study of gastro-oesophageal reflux has been revolutionized by the
development of combined 24-h esophageal pH and multichannel intraluminal impedance (MII)
monitoring.
Combined esophageal MII and pH-monitoring allow for the timed correlation of esophageal pH
changes with reflux events and achieve high sensitivity for the detection of acid (pH <4),
weakly acidic (pH 4-7) and weakly alkaline (pH >7) reflux episodes. Use of this technology
is bringing into focus the potential role of weakly acidic and weakly alkaline reflux in
symptoms that persist despite acid suppressive therapy or anti-reflux surgery.
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Observational Model: Cohort, Time Perspective: Prospective