Universität zu Köln

Babic, Benjamin, Mueller, Dolores T., Gebauer, Florian, Schiffmann, Lars Mortimer, Datta, Rabi R., Schroeder, Wolfgang, Bruns, Christiane J., Leers, Jessica M. and Fuchs, Hans F. (2021). Gastrointestinal function testing model using a new laryngopharyngeal pH probe (Restech) in patients after Ivor-Lewis esophagectomy. World J. Gastrointest. Oncol., 13 (6). PLEASANTON: BAISHIDENG PUBLISHING GROUP INC. ISSN 1948-5204

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Abstract

BACKGROUND There is no established correlation between 24-h esophageal pH-metry (Eso-pH) and the new laryngopharyngeal pH-monitoring system (Restech) as only small case series exist. Eso-pH was not designed to detect laryngopharyngeal reflux (LPR) and Restech may detect LPR better. We have previously published a dataset using the two techniques in a large patient collective with gastroesophageal reflux disease. Anatomically, patients after esophagectomy were reported to represent an ideal human reflux model as no reflux barrier exists. AIM To use a human reflux model to examine our previously published correlation in these patients. METHODS Patients after Ivor Lewis esophagectomy underwent our routine follow-up program with surveillance endoscopies, computed tomography scans and further exams following surgery. Only patients with a complete check-up program and reflux symptoms were offered inclusion into this prospective study and evaluated using Restech and simultaneous Eso-pH. Subsequently, the relationship between the two techniques was evaluated RESULTS A total of 43 patients from May 2016 - November 2018 were included. All patients presented with mainly typical reflux symptoms such as heartburn (74%), regurgitation (84%), chest pain (58%), and dysphagia (47%). Extraesophageal symptoms such as cough, hoarseness, asthma symptoms, and globus sensation were also present. Esophageal 24-hour pH-metry was abnormal in 88% of patients with a mean DeMeester Score of 229.45 [range 26.4-319.5]. Restech evaluation was abnormal in 61% of cases in this highly selective patient cohort. All patients with abnormal supine LPR were also abnormal for supine esophageal reflux measured by conventional Eso-pH. CONCLUSION Patients following esophagectomy and reconstruction with gastric interposition can ideally serve as a human reflux model. Interestingly, laryngopharyngeal reflux phases occur mainly in the upright position. In this human volume-reflux model, results of simultaneous esophageal and laryngopharyngeal (Restech) pH-metry showed 100% correlation as being explicable by one of our reflux scenarios.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Babic, Benjamin UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller, Dolores T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Gebauer, Florian UNSPECIFIED UNSPECIFIED UNSPECIFIED Schiffmann, Lars Mortimer UNSPECIFIED UNSPECIFIED UNSPECIFIED Datta, Rabi R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schroeder, Wolfgang UNSPECIFIED UNSPECIFIED UNSPECIFIED Bruns, Christiane J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Leers, Jessica M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Fuchs, Hans F. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-565519
DOI:	10.4251/wjgo.v13.i6.612
Journal or Publication Title:	World J. Gastrointest. Oncol.
Volume:	13
Number:	6
Date:	2021
Publisher:	BAISHIDENG PUBLISHING GROUP INC
Place of Publication:	PLEASANTON
ISSN:	1948-5204
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language GASTROESOPHAGEAL-REFLUX DISEASE; NORMAL VALUES; DIAGNOSIS; SYMPTOMS; DEFINITION; VALIDATION; CANCER Multiple languages Oncology; Gastroenterology & Hepatology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/56551