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Anterior gastropexy prevents gastrostomy-induced gastroesophageal reflux: an experimental study in piglets.

Abstract：

:There is evidence that gastrostomy can induce gastroesophageal reflux (GER). We used pH monitoring in piglets to evaluate GER after gastrostomy and to assess the effect of anterior gastropexy. Oesophageal pH studies were performed before and after gastrostomy with (8) and without (9) anterior gastropexy. The reflux score was the percentage of time that pH was below 4.0. Short episodes (mean reflux score 2.6%; range, 1.6% to 30%) of GER occurred in half of the animals before surgery. After gastrostomy, reflux episodes occurred more frequently (77% of animals) and were more prolonged (mean reflux score 35.2%; P less than .001). Anterior gastropexy with gastrostomy prevented GER in all 6 piglets with an intact gastropexy. In two animals with reflux after gastrostomy with gastropexy the gastropexy appeared dehiscent at autopsy. Microscopic ulcerative esophagitis was present in more than half the animals with a positive pH study. We conclude that (1) piglets demonstrate short episodes of spontaneous GER; (2) gastrostomy increases the duration and incidence of the GER episodes; (3) anterior gastropexy prevents gastrostomy-induced GER in piglets; and (4) gastrostomy in piglets is a suitable model for studying GER. We advocate protective anterior gastropexy when performing a feeding gastrostomy.

journal_name

J Pediatr Surg

journal_title

Journal of pediatric surgery

authors

Heij HA,Seldenrijk CA,Vos A

doi

10.1016/0022-3468(91)90706-y

subject

Has Abstract

pub_date

1991-05-01 00:00:00

pages

557-9

issue

5

eissn

0022-3468

issn

1531-5037

pii

0022-3468(91)90706-Y

journal_volume

26

pub_type

杂志文章

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