title: Role of intra-oesophageal impedance monitoring in the evaluation of endoscopic gastroplication for gastro-oesophageal reflux disease.
abstract: BACKGROUND
  In the evaluation of several endoscopic antireflux procedures, a discrepancy in the degree of improvement between symptoms and objective reflux parameters as measured by pH-metry has been reported.
  
  
  OBJECTIVE
  To assess the additional value of impedance monitoring in the evaluation of endoscopic gastroplication for gastro-oesophageal reflux disease.
  
  
  METHODS
  Eighteen patients with gastro-oesophageal reflux disease were treated with three endoscopic gastroplications, and underwent 24 h pH-impedance monitoring before and 3 months after treatment.
  
  
  RESULTS
  Total reflux exposure time as assessed by pH-metry and impedance monitoring was significantly decreased after treatment (P = 0.047 and <0.001, respectively). When assessed with impedance monitoring, the mean number of reflux episodes was significantly decreased after the procedure (82 vs. 56, pre vs. post, P < 0.001). Furthermore, the mean numbers of liquid and acid reflux episodes in patients with symptomatic improvement were significantly reduced after treatment (P = 0.04 and 0.02, respectively). After treatment, mean volume clearance time (s) and mean number of proximal reflux episodes were significantly decreased (P < 0.001 and 0.002, respectively).
  
  
  CONCLUSIONS
  Impedance monitoring can identify the specific effect of endoscopic gastroplication on the different types of reflux episodes with regard to gas-liquid composition and pH, as well as on volume clearance and the proximal extent of the refluxate.
authors.affiliation: Department of Gastroenterology and Hepatology, University Medical Center, Utrecht, The Netherlands. jconchillo@hotmail.com
authors.forename: J M
authors.initials: JM
authors.lastname: Conchillo
authors.forename: M P
authors.initials: MP
authors.lastname: Schwartz
authors.forename: M
authors.initials: M
authors.lastname: Selimah
authors.forename: M
authors.initials: M
authors.lastname: Samsom
authors.forename: J
authors.initials: J
authors.lastname: Arts
authors.forename: J
authors.initials: J
authors.lastname: Tack
authors.forename: D
authors.initials: D
authors.lastname: Sifrim
authors.forename: A J P M
authors.initials: AJ
authors.lastname: Smout
mesh_terms: D000328:Adult; D017097:Electric Impedance; D016099:Endoscopy, Gastrointestinal / Q000379:methods; D050782:Esophageal pH Monitoring / Q000592:standards*; D004947:Esophagus / Q000378:metabolism*; D005260:Female; D005764:Gastroesophageal Reflux / Q000378:metabolism* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D013514:Surgical Procedures, Operative / Q000379:methods; D016896:Treatment Outcome