Skip to main content
SpringerLink
Log in

Influence of laparoscopy-aided gastrostomy on gastroesophageal reflux in neurologically impaired patients using multichannel intraluminal impedance pH measurements

  • Original Article
  • Published:
Esophagus Aims and scope Submit manuscript

Abstract

Background

Development of gastroesophageal reflux disease (GERD) after gastrostomy remains debatable. Therefore, this study aimed to evaluate whether laparoscopy-aided gastrostomy (LAG) influence on the occurrence of GERD in neurologically impaired (NI) patients. Furthermore, we investigated whether preoperatively excluding NI patients with GERD can reduce the number of patients requiring subsequent anti-reflux surgery (ARS) after LAG.

Methods

This retrospective study included 35 NI patients (median age: 11.0; interquartile range 5.0–23.5 years) who underwent LAG according to our criterion from October 2012 to June 2020 and MII-pH before and after LAG. MII-pH parameters were compared in all patients and among three age groups between before and after LAG.

Results

There were no significant differences in MII-pH parameters before and 1 year after LAG in all patients, and no patient underwent subsequent ARS. Only one paediatric patient with 64 number of reflux episodes before LAG required subsequent ARS 3 years after LAG.

Conclusions

Generally, LAG did not influence the postoperative GERD at 1 year after LAG, and our criteria could reduce the number of patients requiring subsequent ARS. However, paediatric NI patients with higher number of reflux episodes in preoperative MII-pH study may need careful long-term follow-up after LAG.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Kawahara H, Kubota A, Okuyama H, et al. One-trocar laparoscopy-aided gastrostomy in handicapped children. J Pediatr Surg. 2006;41:2076–80.

    Article  Google Scholar 

  2. Suksamanapun N, Mauritz FA, Franken J, et al. Laparoscopic versus percutaneous endoscopic gastrostomy placement in children: results of a systematic review and meta-analysis. J Minim Access Surg. 2017;13:81–8.

    PubMed  PubMed Central  Google Scholar 

  3. Khattak IU, Kimber C, Kiely EM, et al. Percutaneous endoscopic gastrostomy in paediatric practice: complications and outcome. J Pediatr Surg. 1998;33:67–72.

    Article  CAS  Google Scholar 

  4. Sulaeman E, Udall JN, Brown RF, et al. Gastroesophageal reflux and Nissen fundoplication following percutaneous endoscopic gastrostomy in children. J Pediatr Gastroenterol Nutr. 1998;26:269–73.

    Article  CAS  Google Scholar 

  5. Kawahara H, Tazuke Y, Soh H, et al. Does laparoscopy-aided gastrostomy placement improve or worsen gastroesophageal reflux in patients with neurological impairment? J Pediatr Surg. 2014;49:1742–5.

    Article  Google Scholar 

  6. Franken J, Stellato RK, Tytgat SHAJ, et al. Gastro-esophageal reflux after laparoscopic gastrostomy placement in children. J Pediatr Gastroenterol Nutr. 2020;70:e41–7.

    Article  Google Scholar 

  7. Toporowska Kowalska E, Gębora Kowalska B, Jabłoński J, et al. Influence of percutaneous endoscopic gastrostomy on gastro-oesophageal reflux evaluated by multiple intraluminal impedance in children with neurological impairment. Dev Med Child Neurol. 2011;53:938–43.

    Article  Google Scholar 

  8. Thomson M, Rao P, Rawat D, et al. Percutaneous endoscopic gastrostomy and gastro-oesophageal reflux in neurologically impaired children. World J Gastroenterol. 2011;17:191–6.

    Article  Google Scholar 

  9. Berman L, Sharif I, Rothstein D, et al. Concomitant fundoplication increases morbidity of gastrostomy tube placement. J Pediatr Surg. 2015;50:1104–8.

    Article  Google Scholar 

  10. Kawahara H, Mitani Y, Nose K, et al. Should fundoplication be added at the time of gastrostomy placement in patients who are neurologically impaired? J Pediatr Surg. 2010;45:2373–6.

    Article  Google Scholar 

  11. Plantin I, Arnbjörnsson E, Larsson L-T. No increase in gastroesophageal reflux after laparoscopic gastrostomy in children. Pediatr Surg Int. 2006;22:581–4.

    Article  Google Scholar 

  12. Heine RG, Reddihough DS, Catto Smith AG. Gastro-oesophageal reflux and feeding problems after gastrostomy in children with severe neurological impairment. Dev Med Child Neurol. 1995;37:320–9.

    Article  CAS  Google Scholar 

  13. Wenzl TG, Benninga MA, Loots CM, et al. Indications, methodology, and interpretation of combined esophageal impedance-pH monitoring in children: ESPGHAN EURO-PIG. J Pediatr Gastroenterol Nutr. 2012;55(2):230–4.

    Article  Google Scholar 

  14. Quitadamo P, Tambucci R, Mancini V, et al. Esophageal pH-impedance monitoring in children: position paper on indications, methodology and interpretation by the SIGENP working group. Dig Liver Dis. 2019;51:1522–36.

    Article  Google Scholar 

  15. Fukahori S, Kawahara H, Oyama T, et al. Standard protocol devised by the Japanese Pediatric Impedance Working Group for combined multichannel intraluminal impedance-pH measurements in children. Surg Today. 2020;50:664–71.

    Article  Google Scholar 

  16. Fukahori S, Yagi M, Ishii S, et al. Analyses of the relationship between a “number of reflux episodes” exceeding 70 and the pH index in neurologically impaired children by evaluating esophageal combined pH-multichannel intraluminal impedance measurements. Scand J Gastroenterol. 2018;53:519–26.

    Article  CAS  Google Scholar 

  17. Samuel M, Holmes K. Quantitative and qualitative analysis of gastroesophageal reflux after percutaneous endoscopic gastrostomy. J Pediatr Surg. 2002;37:256–61.

    Article  CAS  Google Scholar 

  18. Wilson GJP, van der Zee DC, Bax NMA. Endoscopic gastrostomy placement in the child with gastroesophageal reflux: is concomitant antireflux surgery indicated? J Pediatr Surg. 2006;41:1441–5.

    Article  Google Scholar 

  19. Aumar M, Lalanne A, Guimber D, et al. Influence of percutaneous endoscopic gastrostomy on gastroesophageal reflux disease in children. J Pediatr. 2018;197:116–20.

    Article  Google Scholar 

  20. Mousa HM, Rosen R, Woodley FW, et al. Esophageal impedance monitoring for gastroesophageal reflux. J Pediatr Gastroenterol Nutr. 2011;52:129–39.

    Article  Google Scholar 

  21. Cresi F, Cester EA, Salvatore S, et al. Multichannel intraluminal impedance and ph monitoring: a step towards pediatric reference values. J Neurogastroenterol Motil. 2020;26:370–7.

    Article  Google Scholar 

  22. Rosen R, Nurko S. The importance of multichannel intraluminal impedance in the evaluation of children with persistent respiratory symptoms. Am J Gastroenterol. 2004;99:2452–8.

    Article  Google Scholar 

  23. Pandolfino JE, Vela MF. Esophageal-reflux monitoring. Gastrointest Endosc. 2009;69:917–30.

    Article  Google Scholar 

  24. Pilic D, Fröhlich T, Nöh F, et al. Detection of gastroesophageal reflux in children using combined multichannel intraluminal impedance and pH measurement: data from the German Pediatric Impedance Group. J Pediatr. 2011;158:650–4.

    Article  Google Scholar 

  25. Yap BKY, Nah SA, Chen Y, et al. Fundoplication with gastrostomy vs gastrostomy alone: a systematic review and meta-analysis of outcomes and complications. Pediatr Surg Int. 2017;33:217–28.

    Article  Google Scholar 

Download references

Acknowledgements

The authors thank ENAGO for editing this manuscript.

Funding

No funding declared.

Author information

Authors and Affiliations

  1. Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan

    Daisuke Masui, Suguru Fukahori, Naoki Hashizume, Shinji Ishii, Naruki Higashidate, Yoshinori Koga, Saki Sakamoto, Shiori Tsuruhisa, Hirotomo Nakahara, Nobuyuki Saikusa & Yoshiaki Tanaka

  2. Division of Medical Safety Management, Kurume University School of Medicine, Fukuoka, Japan

    Yoshiaki Tanaka

Authors
  1. Daisuke Masui
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Suguru Fukahori
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Naoki Hashizume
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shinji Ishii
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Naruki Higashidate
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yoshinori Koga
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Saki Sakamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Shiori Tsuruhisa
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Hirotomo Nakahara
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Nobuyuki Saikusa
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Yoshiaki Tanaka
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

DM and SF designed the research study, analyzed the data, and wrote the paper; YT designed the research study and wrote the paper; SI and NH analyzed the data; NS, NH, YK, SS, ST, and HN performed the research.

Corresponding author

Correspondence to Daisuke Masui.

Ethics declarations

Ethical statement

The protocol of this study has been approved by the Kurume University Ethical Committee (No. 20133). Informed consent was obtained from the families before starting this study.

Conflict of interest

The authors report no conflicts of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Masui, D., Fukahori, S., Hashizume, N. et al. Influence of laparoscopy-aided gastrostomy on gastroesophageal reflux in neurologically impaired patients using multichannel intraluminal impedance pH measurements. Esophagus 19, 360–366 (2022). https://doi.org/10.1007/s10388-021-00888-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10388-021-00888-0

Keywords

Search

Navigation