Pre and Post-Operative Ph-Metry in Videolaparoscopic Surgery for Gastro Oesophageal Reflux Disease

Area of Science:

• Pediatric Gastroenterology
• Surgical Innovation

Background:

• Gastro-oesophageal reflux (GER) is common in children, particularly infants, and can be physiological.
• Immature anatomical structures in infants increase the risk of GER disease, leading to symptoms and potential complications like oesophagitis and stenosis.
• GER disease diagnosis involves morphological and functional assessments, with pH-metry enabling personalized therapeutic strategies.

Purpose of the Study:

• To evaluate the effectiveness of minimally invasive surgical approaches for pediatric reflux disease.
• To assess the role of pH-metry in planning and monitoring treatment outcomes in children with GER disease.

Main Methods:

• Retrospective analysis of 18 children with reflux disease treated with videolaparoscopic Nissen (14) or Toupet (4) fundoplication.
• Pre- and post-operative pH-metry to evaluate esophageal acid exposure and clearance.
• Utilized pH-metry for therapeutic strategy planning and follow-up monitoring, especially in neurologically impaired children.

Main Results:

• Videolaparoscopic surgery significantly improved the functioning of the gastro-oesophageal junction.
• Post-operative pH-metry demonstrated reduced distal esophageal acid exposure and improved esophageal clearance.
• pH-metry proved valuable for therapeutic planning and avoiding invasive tests in follow-up evaluations.

Conclusions:

• Minimally invasive surgery, including Nissen and Toupet fundoplication, is effective for treating pediatric reflux disease.
• pH-metry is an invaluable tool for diagnosing, planning treatment, and monitoring outcomes in children with GER disease.
• This approach is particularly beneficial for managing GER in children with severe neurological impairment.