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Beziehung zwischen Funktionsendoskopie und Impedanz-pH-Metrie

Relationship between functional endoscopy and impedance–pH measurement. German version

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Zusammenfassung

Die klassischen gastroenterologischen diagnostischen Werkzeuge stellen sich zunehmend als unzureichend für die schwierige kausale Zuordnung extraösophagealer Symptome zu einer vermuteten pathologischen Refluxaktivität dar. Einige neue methodische Ansätze, wie die funktionelle Endoskopie („videopanendoscopy“, VPE), werden als hilfreich propagiert. Allerdings fehlen bisher noch Daten, die den Nutzen dieser Untersuchung objektiv belegen. In einer Pilotstudie wurde eine gute Korrelation des Reflux-Symptom-Index zu den Befunden der Endoskopie dokumentiert. Die Impedanz-pH-Metrie gilt aktuell als „Goldstandard“ der Diagnostik der ösophagealen Refluxkrankheit. Ergänzend wurde jetzt die Beziehung funktionsendoskopischer Befunde zu den Ergebnissen der Impedanz-pH-Metrie bei Patienten mit extraösophagealen Symptomen untersucht. Dabei stellte sich heraus, dass pathologische Befunde der VPE mit den Ergebnissen der Impedanz-pH-Metrie in Bezug auf die Parameter „Refluxanzahl“, „Fraktionszeit“ und „DeMeester-Score“ gut korrelieren.

Abstract

Classic gastroenterological diagnostic tools are proving increasingly insufficient for analyzing the complex causal relationship between extra-esophageal symptoms and presumed pathological reflux activity. Some new methodological approaches, such as functional endoscopy (videopanendoscopy, VPE), are considered to be helpful. However, there are currently no data objectively verifying the usefulness of this method. In a pilot study, a good correlation between the reflux symptom index (RSI) and endoscopic findings was shown. Impedance–pH measurement is considered to be the “gold standard” in esophageal reflux disease diagnostics. Therefore, the relationship between endoscopic findings and the results of impedance–pH monitoring are now studied in patients with extra-esophageal reflux symptoms. The investigation demonstrates that the pathological findings of VPE correlate well with impedance–pH measurements in terms of the parameters “number of reflux episodes”, “fraction time”, and “DeMeester score”.

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Authors and Affiliations

  1. Refluxzentrum Darmstadt, Darmstadt, Deutschland

    F. Michel, T. Stroh, R. Fritsche & P. Ahrens

  2. HNO Praxis, Kreiskrankenhaus Seeheim-Jugenheim, Hauptstr. 30, 64342, Seeheim-Jugenheim, Deutschland

    F. Michel

  3. Praxis für Viszeralchirurgie, Darmstadt, Deutschland

    T. Stroh & R. Fritsche

Authors
  1. F. Michel
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  2. T. Stroh
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  3. R. Fritsche
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  4. P. Ahrens
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Correspondence to F. Michel.

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Interessenkonflikt

F. Michel, T. Stroh, R. Fritsche und P. Ahrens geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Redaktion

W. Baumgartner, Wien

P. K. Plinkert, Heidelberg

M. Ptok, Hannover

C. Sittel, Stuttgart

N. Stasche, Kaiserslautern

B. Wollenberg, Lübeck

Die englische Version dieses Beitrags ist unter doi:10.1007/s00106-016-0317-5 zu finden.

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Michel, F., Stroh, T., Fritsche, R. et al. Beziehung zwischen Funktionsendoskopie und Impedanz-pH-Metrie. HNO 65, 657–662 (2017). https://doi.org/10.1007/s00106-016-0313-9

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  • DOI: https://doi.org/10.1007/s00106-016-0313-9

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