Influence on GER From Gastrostomy Surgery

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  • Mouri Junko
    Department of Pediatric Surgery, Central Hospital, Aichi Prefectural Colony
  • Iio Kenji
    Department of Pediatric Surgery, Central Hospital, Aichi Prefectural Colony
  • Kato Junji
    Department of Pediatric Surgery, Central Hospital, Aichi Prefectural Colony
  • Niimi Norihiro
    Department of Pediatric Surgery, Central Hospital, Aichi Prefectural Colony
  • Tanaka Shuichi
    Department of Pediatric Surgery, Central Hospital, Aichi Prefectural Colony

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  • 胃瘻造設術と術後胃食道逆流との関係について
  • イロウゾウセツジュツ ト ジュツゴ イ ショクドウ ギャクリュウ ト ノ カンケイ ニ ツイテ

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Abstract

Purpose: Recently, gastrostomy became common in children with neurological impairment and swallowing disability. Gastroesophageal reflux disease (GERD) is more frequently seen among these patients. We measured lower esophageal pH before and after the gastrostomy procedure to assess the influence of gastrostomy. Methods: The authors have measured lower esophageal pH before and after surgery for 50 children who needed gastrostomy because of swallowing difficulty from January 2006 to December 2009. Examination of the relationship between lower esophageal pH and other factors was done. In the role of evaluation method, reflux index (RI), that is the total percentage of the time below the cut-off, pH4, was calculated. Results: Forty-two children who did not have reflux (preoperative RI<10%) remained reflux free. Four children who had reflux (preoperative RI>10%) came to have no reflux, and 4 children who did not have reflux increased their RI scores. Age at operation, primary disease, and gastrostomy site did not influence RI after gastrostomy. Conclusions: A gastrostomy operation does not influence RI. So a protective antireflux operation simultaneously with gastrostomy is not indicated to prevent GERD in the case of children who have no symptoms.

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