Aralik 2018
Gastroözofageal reflü hastaliginda diyafram kruslari arasindaki açi ile asit reflü siddeti arasindaki iliski: bir retrospektif kohort çalismasi
Relationship between acid reflux severity and the angle between diaphragm crus in gastroesophageal reflux disease: a retrospective cohort study
- Ana Sayfa
- Sayılar
- Aralik 2018
- Gastroözofageal reflü hastaliginda diyafram kruslari arasindaki açi ile asit reflü siddeti arasindaki iliski: bir retrospektif kohort çalismasi...
Özet
Giris ve Amaç: Gastroskopi ve 24 saatlik pH metre gastroözofagealreflü hastaliginin tanisinda altin standarttir. Bu çalisma, 24 saatlik pHmetre ile saptanan asit reflü siddeti ile diyafram kruslari arasi açininiliskisini belirlemeyi amaçlamistir. Gereç ve Yöntem: Haziran 2011 veHaziran 2017 arasinda, gastroözofageal reflü hastaligi olan 32 hastaile 20 normal bireyden elde edilen veriler retrospektif olarak incelendi.Diyafram kruslari arasinda açi ölçümü bilgisayarli tomografi kesitleri üzerinden yapildi.Bulgular: Diyafram kruslari arasindaki açinin genislemesiile DeMeester skorunun yüksekligi arasinda anlamli olarak orantili iliskibulundu (p <0.004). DeMeester skoru ?14.7 olan hastalarda daha dü-sük DeMeester skoru olanlara göre bu açinin ortalama degeri anlamliolarak daha yüksekti (p=0.033). Kruslar arasi açi normal bireylerde gastroözofageal reflü hastaligi olanlarla karsilastirildiginda anlamli derecededaha düsüktü (normal birey ile DeMeester ?14.7 olan gastroözofagealreflü hastalikli birey, p=0.001; normal birey ile DeMeester <14.7 olangastroözofageal reflü hastalikli birey, p=0.04). DeMeester skorunun?14.7 olarak kestirilmesinde, açinin 65º ve üzeri olmasinin duyarliligi%94.4, özgüllügü %42.9, pozitif kestirim degeri %68.0 ve negatif kestirim degeri %85.7 olarak saptandi. Sonuç: Bu çalismanin sonuçlari,diyafram kruslari arasi açi ile asit reflü siddeti arasinda açik bir iliski oldugunu göstermektedir. Bilgisayarli tomografi kruslar arasindaki açi
Abstract
Background and Aims: Gastroscopy and 24-hour pH monitoring arecurrently the gold standards in diagnosing gastroesophageal reflux disease. This study aims to define the association between the acid refluxseverity, as determined by the 24-hour pH monitoring, and the grade ofthe intercrural angle.Material and Methods:The clinical data from 32patients with gastroesophageal reflux disease and 20 normal individualswithout gastroesophageal reflux disease were retrospectively analyzed.The intercrural angle of all patients was measured using computedtomography and compared with the DeMeester score. Results: A significant proportional relationship was found between the enlargementof the angle between crura and the DeMeester score (p <0.004). Theintercrural angle was significantly higher in patients with a DeMeesterscore ?14.7 than in those with a lower DeMeester score (p=0.033). Theintercrural angle was also significantly lower in normal individuals whencompared with patients with gastroesophageal reflux disease (normalindividual vs gastroesophageal reflux disease with DeMeester score?14.7, p=0.001; normal individual vs gastroesophageal reflux diseasewith a DeMeester score <14.7, p=0.04). The cutoff threshold for theangle between crura in predicting a DeMeester score ?14.7 was ?65ºwith 94.4% sensitivity, 42.9% specificity, 68% positive predictive valueand 85.7% negative predictive value. Conclusion: Results of the present study indicate an association between the angle between crura andacid reflux severity. Computed tomography can be an ancillary methodbefore anti-reflux surgery as it calculates the angle between crura.
