title: [Gastroesophageal reflux disease. Evaluation and indication for surgical treatment by esophageal phmetry].
abstract: BACKGROUND
  Oesophageal pH monitoring is considered the best procedure to assess the severity of gastroesophageal reflux disease (GERD), conditioning its treatment. The indication for surgery is becoming less common. We intend to meet this test to what extent it has influenced.
  
  
  METHODS
  We recruit patients treated in our Centre since the introduction of pH monitoring. We compare the number of times before and after its use. We value clinical manifestations, usual pH metric values versus non-operated patients with pathological test, associated pathology.
  
  
  RESULTS
  
  
  
  METHODS
  91 patients, 151 pH metric studies (98 preoperative). Number of interventions prior to introduction of pH monitoring: 20/year, post: 3.79/year.
  
  
  METHODS
  gastrointestinal 60.2%, respiratory 10.2%, mixed 24.5%. 495 non-operated patients, 692 pathological studies. PH metric values operated/not operated: No. reflux 116.91 +/- 125.46/101.69 +/- 83.39 (p < 0.001), No. reflux >5 minutes 8.49 +/- 8.28/4.43 +/- 4.85 (p = 0.001), longest reflux 60.21 +/- 95.93/31.16 +/- 80.09 (p < 0.001), clearance 1.27 +/- 1.44/0.86 +/- 1.05 (p = 0.04), DeMeester 52.74 +/- 56.21/29.49 +/- 23.57 (p < 0.001). 14 of 98 preoperative pH monitoring were normal. Associated pathology operated/not operated: 13.26%/ 7.47%.
  
  
  CONCLUSIONS
  The pH metric control of patients with GERD and the progress of medical treatment have led to a decrease in surgical procedures. In our experience, the intensity of GERD is a valuable parameter in deciding on the surgery. We attach particular value parameters measuring oesophageal clearance and indices that integrate several of them. However, in some patients without pathological pH monitoring, we have indicated the operation. The prevalence of associated pathology in the operated makes us value them more demanding.
authors.affiliation: Hospital Materno Infantil Infanta Cristina, SES. UEX, Grupo de Investigación en Pediatría PAIDOS (CTS 019), Badajoz.
authors.forename: E
authors.initials: E
authors.lastname: Enríquez Zarabozo
authors.forename: C
authors.initials: C
authors.lastname: Moreno Hurtado
authors.forename: E
authors.initials: E
authors.lastname: Blesa Sánchez
authors.forename: I
authors.initials: I
authors.lastname: Vargas Muñoz
authors.forename: S
authors.initials: S
authors.lastname: Amat Valero
authors.forename: R
authors.initials: R
authors.lastname: Ayuso Velasco
mesh_terms: D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D050782:Esophageal pH Monitoring; D005260:Female; D005764:Gastroesophageal Reflux / Q000378:metabolism / Q000601:surgery*; D006801:Humans; D008297:Male; D012189:Retrospective Studies