Selective preoperative ambulatory esophageal pH monitoring is sufficient for patients undergoing laparoscopic antireflux surgery

T. L. Trus, N. M. Selim, W. S. Richardson, J. M. Wo, G. D. Branum, S. J. Mauren, J. P. Waring, J. G. Hunter

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Abstract

We have previously shown that routine preoperative ambulatory esophageal pH monitoring is of marginal benefit in patients with endoscopic esophagitis and heartburn. The aim of this study was to compare the results of laparoscopic antireflux surgery (LAS) in patients who had routine preoperative pH study to those who did not have a preoperative pH study. Methods: Of 340 patients who underwent LAS, 155 underwent pH study as part of a routine preoperative workup (Group 1). More recently, 185 patients without endoscopic esophagitis did not undergo pH study (Group 2). Symptoms of chest pain, heartburn, and dysphagia were scored from 0 (none) to 4 (severe) before, six weeks after and one year after surgery. One year follow up data were available for 83 and 31 patients in groups 1 and 2, respectively. Symptom scores were compared using the Mann-Whitney U test. Results: There were no differences between the two groups with respect to age. gender, and preoperative symptom scores. Both groups experienced significant improvement in reflux symptoms six weeks and one year postoperatively. There were no differences in postoperative symptom scores between the two groups. Group 1 mean (SD) Group 2 mean (SD) preop 6 wk 1 yr preop 6 wk 1 yr Chest Pain 1.3(1.3)* .4 (.7) .3 (.7) 1.2 (1.3)* .7 (1.1) .3 (.6) Heartburn 2.8 (1.2)* .2 (.7) .4 (.9) 2.9 (1.3)* .2 (.6) .3 (.7) Dysphagia 1.4 (1.4)* .6 (.9) .4 (.7) 1.3(1.4)* .7 (1) .3 (.6) * p<0.05 preop vs. 6 wk. and 1 yr. postop p=NS Group 1 vs. Group 2, preop, 6 wk. and 1 yr. postop Conclusion: Selective preoperative ambulatory pH monitoring does not adversely affect the outcome of laparoscopic antireflux surgery.

Original languageEnglish (US)
Number of pages1
JournalGastrointestinal endoscopy
Volume43
Issue number4
DOIs
StatePublished - Jan 1 1996

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ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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