Evidence map›Paper›PMID 28365914›Full record

ArticleObesity surgery2017

The Physiology and Pathophysiology of Gastroesophageal Reflux in Patients with Laparoscopic Adjustable Gastric Band.

Richard Y Chen, Paul R Burton, Geraldine J Ooi, Cheryl Laurie, Andrew I Smith, Gary Crosthwaite, Paul E O'Brien, Geoff Hebbard, Peter D Nottle, Wendy A Brown

Abstract read
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Article in Obesity surgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. Article
  5. Bariatric surgery and gastroesophageal reflux disease.Annals of translational medicine · 2020
    Review
  6. Review
  7. Article
  8. Observational
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Richard Y ChenCentre for Obesity Research and Education, Monash University, Level 6, The Alfred Centre, 99 Commercial Rd, Melbourne, 3181, Australia.
Paul R BurtonCentre for Obesity Research and Education, Monash University, Level 6, The Alfred Centre, 99 Commercial Rd, Melbourne, 3181, Australia. paul.burton@monash.edu.
Geraldine J OoiCentre for Obesity Research and Education, Monash University, Level 6, The Alfred Centre, 99 Commercial Rd, Melbourne, 3181, Australia.
Cheryl LaurieCentre for Obesity Research and Education, Monash University, Level 6, The Alfred Centre, 99 Commercial Rd, Melbourne, 3181, Australia.
Andrew I SmithUpper Gastrointestinal Surgical Unit, The Alfred Hospital, Melbourne, Australia.
Gary CrosthwaiteDepartment of Surgery, Royal Melbourne Hospital, Parkville, Australia.
Paul E O'BrienCentre for Obesity Research and Education, Monash University, Level 6, The Alfred Centre, 99 Commercial Rd, Melbourne, 3181, Australia.
Geoff HebbardDepartment of Gastroenterology, Royal Melbourne Hospital, Parkville, Australia.
Peter D NottleUpper Gastrointestinal Surgical Unit, The Alfred Hospital, Melbourne, Australia.
Wendy A BrownCentre for Obesity Research and Education, Monash University, Level 6, The Alfred Centre, 99 Commercial Rd, Melbourne, 3181, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe effect of the laparoscopic adjustable gastric band (LAGB) on esophageal acid exposure and reflux is poorly understood. Optimal technique and normative values for acid exposure have not been established in this group.

methodsHigh-resolution manometry (HRM) and 24-h ambulatory esophageal pH monitoring were performed in three groups: asymptomatic LAGB, symptomatic LAGB, and pre-operative reflux patients. This technique utilized intraluminal pressure signatures during HRM to guide accurate pH sensor placement.

resultsThe LAGB groups were well matched: age 48 vs 51 years (p = 0.249), weight loss 27.3 vs 26.7 kg (p = 0.911). The symptomatic group had a larger gastric pouch (5.2 vs 3.3 cm, p = 0.012), with higher esophageal acid exposure (10.8 vs 0.9%, p < 0.001). Two acidification patterns were observed: irritant and volume acidification, associated with substantial supine acidification. Symptomatic LAGB had altered esophageal motility, with poorer lower esophageal sphincter basal tone (8.0 vs 17.7 mmHg, p = 0.022) and impaired contractility of the lower esophageal segment (90 vs 40%, p = 0.009). Compared to pre-operative reflux patients, symptomatic LAGB patients demonstrated higher total and supine esophageal acid exposure (10.8 vs 7.0%, p = 0.010; 14.9 vs 5.1%, p < 0.001), less symptoms (2 vs 6, p = 0.001) and lower symptom index (0.7 vs 0.9, p = 0.010).

conclusionsAmbulatory pH monitoring is an effective technique if the pH sensor is positioned appropriately using HRM. The correctly positioned LAGB appears associated with low esophageal acidification. In contrast, patients with symptoms or pouch dilatation can have markedly elevated esophageal acidification, particularly when supine. This is a different pattern compared to pre-operative patients and importantly can be disproportionate to symptoms.

Indexed as

Bariatric SurgeryGastroesophageal RefluxLaparoscopyEsophageal pH MonitoringHumansManometryMiddle AgedBariatric surgeryEsophageal dysmotilityEsophageal motilityEsophageal pH monitoringGastric bandGastroesophageal refluxObesity

Identifiers

PMID28365914

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.