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Article

High Resolution Manometry Guidance During Laparoscopic Fundoplication in Pediatric Surgically “Fragile” Patients: Preliminary Report

1
Pediatric Surgery Unit, Children’s Hospital, ARNAS Civico-Di Cristina-Benfratelli, 90127 Palermo, Italy
2
Pediatric and Adolescent Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy
3
Pediatric Unit, “V. Buzzi” Children’s Hospital, University of Milano, 20154 Milano, Italy
4
Pediatric Surgery Unit, “V. Buzzi” Children’s Hospital, University of Milano, 20154 Milano, Italy
5
Department of Biomedical and Clinical Science, “L. Sacco”, University of Milano, 20154 Milano, Italy
*
Author to whom correspondence should be addressed.
Children 2020, 7(11), 215; https://doi.org/10.3390/children7110215
Received: 6 October 2020 / Revised: 4 November 2020 / Accepted: 5 November 2020 / Published: 7 November 2020
(This article belongs to the Special Issue Pediatric Gastroenterology and Nutrition)
Background: High resolution manometry (HRM), has been recently introduced in clinical practice to detect esophageal intraluminal pressure and esophageal motor function. We evaluated the feasibility and usefulness of intraoperative esophageal HRM during antireflux laparoscopic procedures in pediatric cases with neurological impairment (NI) or esophageal atresia (EA). Methods: From January to November 2019, seven children (5 NI, 2 EA) with gastroesophageal reflux (GER) were enrolled. Data on intraoperative pressure changes of the esophagogastric junction (EGJ) and postoperative follow-up data were collected. Results: Average preoperative LES pressures were not significantly different from postoperative pressures. A sliding hernia was detected in all patients as evidenced by EGJ double peak pressures. Hernia correction after esophageal traction was complete in 71.4% of the patients, and residual hernia (<2 cm) was detected in 28.6%. Postoperative EGJ pressures were higher compared to preoperative sphincteric pressures (p < 0.001); in NI patients, higher postoperative values were noted compared to EA (p = 0.05). No sliding hernia and/or GER relapses were recorded. Two patients reported dysphagia postoperatively. Conclusions: Intraoperative HRM may optimize esophageal pressure changes during laparoscopic fundoplication. Further studies are needed to confirm the usefulness of a tailored surgical approach to reduce postoperative complications. View Full-Text
Keywords: high resolution; manometry; pediatric laparoscopic fundoplication high resolution; manometry; pediatric laparoscopic fundoplication
MDPI and ACS Style

Caruso, A.M.; Milazzo, M.; Tulone, V.; Acierno, C.; Girgenti, V.; Amoroso, S.; Bommarito, D.; Calcaterra, V.; Pelizzo, G. High Resolution Manometry Guidance During Laparoscopic Fundoplication in Pediatric Surgically “Fragile” Patients: Preliminary Report. Children 2020, 7, 215. https://doi.org/10.3390/children7110215

AMA Style

Caruso AM, Milazzo M, Tulone V, Acierno C, Girgenti V, Amoroso S, Bommarito D, Calcaterra V, Pelizzo G. High Resolution Manometry Guidance During Laparoscopic Fundoplication in Pediatric Surgically “Fragile” Patients: Preliminary Report. Children. 2020; 7(11):215. https://doi.org/10.3390/children7110215

Chicago/Turabian Style

Caruso, Anna M., Mario Milazzo, Vincenzo Tulone, Carlo Acierno, Vincenza Girgenti, Salvatore Amoroso, Denisia Bommarito, Valeria Calcaterra, and Gloria Pelizzo. 2020. "High Resolution Manometry Guidance During Laparoscopic Fundoplication in Pediatric Surgically “Fragile” Patients: Preliminary Report" Children 7, no. 11: 215. https://doi.org/10.3390/children7110215

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