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Multichannel Intraluminal Impedance (multichannel + intraluminal_impedance)

Distribution by Scientific Domains
Medical Sciences100%

Selected Abstracts

Multichannel intraluminal impedance for the assessment of post-fundoplication dysphagia

DISEASES OF THE ESOPHAGUS, Issue 5 2006
T. Yigit
SUMMARY., Dysphagia often occurs after fundoplication, although its pathophysiology is not clear. We sought to better understand postfundoplication dysphagia by measuring esophageal clearance with multichannel intraluminal impedance (MII) along with more traditional work-up (manometry, upper gastrointestinal imaging [UGI], endoscopy). We evaluated 80 consecutive patients after laparoscopic fundoplication between April 2002 and November 2004. Patients were evaluated clinically and underwent simultaneous manometry and MII, 24-hour pH monitoring, endoscopy, and UGI. For analysis, patients were divided into the following groups based on the presence of dysphagia and fundoplication anatomy (by UGI/endoscopy): (1) Dysphagia and normal anatomy; (2) Dysphagia and abnormal anatomy; (3) No dysphagia and abnormal anatomy; and (4) No dysphagia and normal anatomy. Patients with dysphagia (Groups 1 & 2) had similar peristalsis (manometry), but were more likely to have impaired clearance by MII (32 pts, 62%) than those without dysphagia (9 pts, 32%, P = 0.01). Patients with abnormal anatomy (Groups 2 & 3) were also more likely to have impaired esophageal clearance (66%vs. 38%, P = 0.01). Finally, of patients that had normal fundoplication anatomy, those with dysphagia were much more likely to have impaired clearance (12 pts, 52%) than those with dysphagia (4 pts, 21%, P = 0.03). MII after fundoplication provides objective evidence of esophageal clearance, and is commonly abnormal in patients with abnormal fundoplication anatomy and/or dysphagia. Esophageal clearance is impaired in the majority of patients with postoperative dysphagia, even with normal fundoplication anatomy and normal peristalsis. MII may detect disorders in esophageal motility not detected by manometry. [source]

Inter-observer agreement for multichannel intraluminal impedance,pH testing

DISEASES OF THE ESOPHAGUS, Issue 7 2010
K. Ravi
SUMMARY Twenty-four-hour ambulatory multichannel intraluminal impedance (MII),pH detects both acid and nonacid reflux (NAR). A computer-based program (AutoscanÔ, Sandhill Scientific, Highlands Ranch, CO, USA) automates the detection of reflux episodes, increasing the ease of study interpretation. Inter-observer agreement between multiple reviewers and with AutoscanÔ for the evaluation of significant NAR with MII,pH has not been studied in the adult population. Twenty MII,pH studies on patients taking a proton pump inhibitor twice daily were randomly selected. AutoscanÔ analyzed all studies using the same pre-programmed parameters. Four reviewers interpreted the MII,pH studies, adding or deleting reflux episodes detected by AutoscanÔ. Positive studies for NAR and total reflux episodes were based on published criteria. Cohen's kappa statistic (,) evaluated inter-observer agreement between reviewers and AutoscanÔ analysis. The average , for pathologic NAR between reviewers was 0.57 (0.47,0.70), and between reviewers and AutoscanÔ was 0.56 (0.4,0.8). When using the total reflux episode number as a marker for pathologic reflux (acid and NAR), the , score was 0.72 (0.61,0.89) between reviewers, and 0.74 (0.53,0.9) when evaluating total reflux episodes. Two reviewers agreed more often with each other and with AutoscanÔ on the number of NAR episodes, while the other two reviewers agreed with each other, but did not agree with either AutoscanÔ or the first two reviewers. Inter-observer agreement between reviewers and AutoscanÔ for detecting pathologic NAR is moderate, with reviewers either excluding more of the AutoscanÔ-defined events or excluding fewer events and therefore agreeing with AutoscanÔ. [source]

Multichannel intraluminal impedance for the assessment of post-fundoplication dysphagia

DISEASES OF THE ESOPHAGUS, Issue 5 2006
T. Yigit
SUMMARY., Dysphagia often occurs after fundoplication, although its pathophysiology is not clear. We sought to better understand postfundoplication dysphagia by measuring esophageal clearance with multichannel intraluminal impedance (MII) along with more traditional work-up (manometry, upper gastrointestinal imaging [UGI], endoscopy). We evaluated 80 consecutive patients after laparoscopic fundoplication between April 2002 and November 2004. Patients were evaluated clinically and underwent simultaneous manometry and MII, 24-hour pH monitoring, endoscopy, and UGI. For analysis, patients were divided into the following groups based on the presence of dysphagia and fundoplication anatomy (by UGI/endoscopy): (1) Dysphagia and normal anatomy; (2) Dysphagia and abnormal anatomy; (3) No dysphagia and abnormal anatomy; and (4) No dysphagia and normal anatomy. Patients with dysphagia (Groups 1 & 2) had similar peristalsis (manometry), but were more likely to have impaired clearance by MII (32 pts, 62%) than those without dysphagia (9 pts, 32%, P = 0.01). Patients with abnormal anatomy (Groups 2 & 3) were also more likely to have impaired esophageal clearance (66%vs. 38%, P = 0.01). Finally, of patients that had normal fundoplication anatomy, those with dysphagia were much more likely to have impaired clearance (12 pts, 52%) than those with dysphagia (4 pts, 21%, P = 0.03). MII after fundoplication provides objective evidence of esophageal clearance, and is commonly abnormal in patients with abnormal fundoplication anatomy and/or dysphagia. Esophageal clearance is impaired in the majority of patients with postoperative dysphagia, even with normal fundoplication anatomy and normal peristalsis. MII may detect disorders in esophageal motility not detected by manometry. [source]

Characterization of reflux events after fundoplication using combined impedance,pH recording,

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 1 2007
S. Roman
Background: Laparoscopic fundoplication effectively controls symptoms of gastro-oesophageal reflux disease (GORD) and decreases acid reflux, but its impact on non-acid reflux is not known. The aim of the study was to characterize reflux events after fundoplication using oesophageal combined multichannel intraluminal impedance (MII),pH monitoring, to demonstrate its efficacy on acid as well as non-acid reflux events. Methods: Thirty-six patients in whom ambulatory MII,pH recording was performed after laparoscopic fundoplication were reviewed retrospectively. There were 23 symptomatic and 13 asymptomatic patients, whose results were compared with those of 72 healthy volunteers. Results: Oesophageal acid exposure was low in all but one operated patient, and there was no difference between those with and without symptoms. The median number of reflux events over 24 h was lower after fundoplication (11 in operated patients compared with 44 in healthy volunteers; P < 0·001). Almost all reflux events were non-acid after surgery whereas acid reflux episodes were predominant in healthy volunteers. Proximal reflux events were less common in operated patients. Non-acid reflux events were significantly associated with symptoms after surgery in some patients. Conclusion: Fundoplication restores a competent barrier for all types of reflux. Reflux events are mostly non-acid after surgery, and such events may be positively correlated with symptoms. Copyright © 2006 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source]