pH Impedance Parameters Associated with Improvement in GERD Health-Related Quality of Life Following Anti-reflux Surgery
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SSAT QUICK SHOT PRESENTATION
pH Impedance Parameters Associated with Improvement in GERD Health-Related Quality of Life Following Anti-reflux Surgery Morgan K. Johnson 1 & Manasa Venkatesh 1 & Natalie Liu 1 & Catherine R. Breuer 1 & Amber L. Shada 1 & Jacob A. Greenberg 1 & Anne O. Lidor 1 & Luke M. Funk 1,2 Received: 1 July 2020 / Accepted: 17 October 2020 # 2020 The Society for Surgery of the Alimentary Tract (This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply
Abstract Introduction pH impedance testing is the most sensitive diagnostic test for detecting gastroesophageal reflux disease (GERD). The literature remains inconclusive on which preoperative pH impedance testing parameters are associated with an improvement in heartburn symptoms after anti-reflux surgery. The objective of this study was to evaluate which parameters on preoperative pH impedance testing were associated with improved GERD health-related quality of life (GERD-HRQL) following surgery. Methods Data from a single-institution foregut database were used to identify patients with reflux symptoms who underwent anti-reflux surgery between 2014 and 2020. Acid and impedance parameters were extracted from preoperative pH impedance studies. GERD-HRQL was assessed pre- and postoperatively with a questionnaire that evaluated heartburn, dysphagia, and the impact of acid-blocking medications on daily life. Patient characteristics, fundoplication type, and four pH impedance parameters were included in a multivariable linear regression model with improvement in GERD-HRQL as the outcome. Results We included 108 patients (59 Nissen and 49 Toupet fundoplications), with a median follow-up time of 1 year. GERDHRQL scores improved from 22.4 (SD ± 10.1) preoperatively to 4.2 (± 6.2) postoperatively. In multivariable analysis, a normal preoperative acid exposure time (p = 0.01) and Toupet fundoplication (vs. Nissen; p = 0.03) were independently associated with greater improvement in GERD-HRQL. Conclusions Of the four pH impedance parameters that were investigated, a normal preoperative acid exposure time was associated with greater improvement in quality of life after anti-reflux surgery. Further investigation into the critical parameters on preoperative pH impedance testing using a multi-institutional cohort is warranted. Keywords GERD . Anti-reflux surgery . pH impedance . QoL
Introduction Gastroesophageal reflux disease (GERD) is the most common gastrointestinal disorder in the United States of America (USA), affecting nearly 25% of the population1, 2. Typical GERD
Meeting Presentation Information: Accepted as a quick shot oral presentation for the Digestive Disease Week Annual Conference on May 2, 2020, in Chicago, IL. * Luke M. Funk [email protected] 1
Department of Surgery, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
2
William S. Middleton Memorial VA Hospital, Madison, WI, USA
symptoms include heartburn and regurgitation, with many patients
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