[Analysis of different factors affecting results of the surgical treatment of gastroesophageal reflux].
Gastric emptying, gastric secretion and esophageal pH were studied prospectively in 32 patients who had either a Lortat-Jacob type operation (n = 7) or a fundoplication with a 360 degrees (n = 4), 270 degrees (n = 5) or 180 degrees (n = 16) gastric fundic wrap. The goal was to determine the effects of various antireflux mechanisms on these functions as well as to try to explain abnormal postoperative esophageal pH scoring indexes. Esophageal pH was recorded during the 3 h period following a standard meal. Acid reflux was expressed using a scoring index taking into account the duration and magnitude of pH fall. Preoperatively, all patients had an abnormal pH scoring index. Postoperatively, the pH scoring index remained increased in 7 patients (group A) and returned to normal values in 25 (group B). Clinical data, esophageal pH parameters and gastric acid secretion measured preoperatively were not significantly different in the two groups of patients. Preoperative gastric emptying for liquids was shorter in group A than in group B patients (p less than 0.05). Postoperative gastric emptying of radiopaque markers was not different in the two groups of patients. Postoperative resting pressure of the lower esophageal sphincter was always less than 10 cm H2O in group A and more than 10 cm H2O in group B patients. Changes in lower esophageal pressure after surgery were higher in group B than in group A patients (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
D000328:Adult; D000368:Aged; D004947:Esophagus / Q000503:physiopathology; D005260:Female; D005744:Gastric Acid / Q000378:metabolism; D005746:Gastric Emptying; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008365:Manometry; D008722:Methods; D008875:Middle Aged; D011183:Postoperative Complications; D011184:Postoperative Period; D011446:Prospective Studies
Analyse des différents facteurs conditionnant les résultats du traitement chirurgical du reflux gastrooesophagien.