Characterization of gastric dysfunction after fundoplication using body surface gastric mapping.

Autor:	Xu W; Department of Surgery, University of Auckland, Auckland, New Zealand., Wang T; Department of Surgery, University of Auckland, Auckland, New Zealand., Foong D; Alimetry Ltd, Auckland, New Zealand; School of Medicine, Western Sydney University, Penrith, Australia., Schamberg G; Department of Surgery, University of Auckland, Auckland, New Zealand; Alimetry Ltd, Auckland, New Zealand., Evennett N; Department of Surgery, University of Auckland, Auckland, New Zealand., Beban G; Department of Surgery, University of Auckland, Auckland, New Zealand., Gharibans A; Alimetry Ltd, Auckland, New Zealand; Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States., Calder S; Alimetry Ltd, Auckland, New Zealand; Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand., Daker C; Alimetry Ltd, Auckland, New Zealand; Department of Gastroenterology, North Shore Hospital, Auckland, New Zealand., Ho V; School of Medicine, Western Sydney University, Penrith, Australia; Department of Gastroenterology and Hepatology, Campbelltown Hospital, Campbelltown, Australia., O'Grady G; Department of Surgery, University of Auckland, Auckland, New Zealand; Alimetry Ltd, Auckland, New Zealand; Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand. Electronic address: greg.ogrady@auckland.ac.nz.
Jazyk:	angličtina
Zdroj:	Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract [J Gastrointest Surg] 2024 Mar; Vol. 28 (3), pp. 236-245. Date of Electronic Publication: 2024 Jan 23.
DOI:	10.1016/j.gassur.2023.12.023
Abstrakt:	Background: Adverse gastric symptoms persist in up to 20% of fundoplication operations completed for gastroesophageal reflux disease, causing significant morbidity and driving the need for revisional procedures. Noninvasive techniques to assess the mechanisms of persistent postoperative symptoms are lacking. This study aimed to investigate gastric myoelectrical abnormalities and symptoms in patients after fundoplication using a novel noninvasive body surface gastric mapping (BSGM) device. Methods: Patients with a previous fundoplication operation and ongoing significant gastroduodenal symptoms and matched controls were included. BSGM using Gastric Alimetry (Alimetry Ltd) was employed, consisting of a high-resolution 64-channel array, validated symptom-logging application, and wearable reader. Results: A total of 16 patients with significant chronic symptoms after fundoplication were recruited, with 16 matched controls. Overall, 6 of 16 patients (37.5%) showed significant spectral abnormalities defined by unstable gastric myoelectrical activity (n = 2), abnormally high gastric frequencies (n = 3), or high gastric amplitudes (n = 1). Patients with spectral abnormalities had higher Patient Assessment of Upper Gastrointestinal Disorders-Symptom Severity Index scores than those of patients without spectral abnormalities (3.2 [range, 2.8-3.6] vs 2.3 [range, 2.2-2.8], respectively; P = .024). Moreover, 7 of 16 patients (43.8%) had BSGM test results suggestive of gut-brain axis contributions and without myoelectrical dysfunction. Increasing Principal Gastric Frequency Deviation and decreasing Rhythm Index scores were associated with symptom severity (r > .40; P < .05). Conclusion: A significant number of patients with persistent postfundoplication symptoms displayed abnormal gastric function on BSGM testing, which correlated with symptom severity. Our findings advance the pathophysiologic understanding of postfundoplication disorders, which may inform diagnosis and patient selection for medical therapy and revisional procedures. (Copyright © 2023. Published by Elsevier Inc.)
Databáze:	MEDLINE
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