Improved Reflux Monitoring in the Acute Gastroesophageal Reflux Porcine Model Using Esophageal Multichannel Intraluminal Impedance Measurement |
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Authors: | Beat Peter Müller-Stich Arianeb Mehrabi Hannes Götz Kenngott Zhoobin Mood Hamidreza Funouni Michael Andreas Reiter Georg Richard Linke Ulf Hinz Carsten Nils Gutt Jörg Köninger |
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Affiliation: | (1) Department of General, Abdominal, and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany;(2) Department of Surgery, Kantonsspital St. Gallen, St. Gallen, Switzerland |
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Abstract: | Background Acute animal models are needed to obtain further insights into the mechanism of gastroesophageal reflux disease. Existing acute models use imprecise methods to detect reflux. The aim of the present study was to evaluate the potential of esophageal multichannel intraluminal impedance measurement (MII) to improve the quality of results of acute reflux porcine models. Materials and Methods MII was used in ten pigs to monitor gastroesophageal reflux. Measurements were obtained (A) before and (B) after mobilization of the esophagus and (C) after myotomy. The results were compared to those obtained when reflux was monitored by esophageal drainage of intragastrically infused blue solution (DBS). Results The times to first appearance of reflux were 67% (A), 86% (B), and 57% (C) of those by DBS when detected by MII; p < 0.05. The respective values for intragastric pressures needed to provoke reflux were 46%, 76%, and 66%; p < 0.05. Although the lower esophageal sphincter pressure decreased by 69% after (B) the intragastric pressure needed to provoke reflux increased by 140%; p < 0.05. Conclusions MII improves the detection of reflux in the acute reflux porcine model. The finding that after sole mobilization of the esophagus the intragastric pressure needed to provoke reflux was increased although the finding that the pressure of the lower esophageal sphincter was decreased needs further investigation. |
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Keywords: | Gastroesophageal reflux disease Lower esophageal sphincter Pathophysiology Acute porcine model Myotomy Esophageal intraluminal impedance measurement Methylene blue |
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