An ambulant porcine model of acid reflux used to evaluate endoscopic gastroplasty. Issue 6 (1st June 1999)

• Record Type: Journal Article
• Authors: Kadirkamanathan, S S; Yazaki, E; Evans, D F; Hepworth, C C; Gong, F; Swain, C P
• Is Part Of: Gut. Volume 44:Issue 6(1999)
• Page Start: 782
• Page End: 788
• Publication Date: 1999-06-01
• Subjects: gastro-oesophageal reflux -- endoscopic gastroplasty -- manometry; Gastroenterology -- Periodicals; 616.33
• DOI: 10.1136/gut.44.6.782
• Languages: English
• ISSNs: 0017-5749

Abstract

Abstract : BACKGROUND: There is a lack of suitable models for testing of therapeutic procedures for gastro-oesophageal reflux disease. Endoscopic sewing methods might allow the development of a new less invasive surgical approach to treatment of gastrointestinal disorders. AIMS: To develop an animal model of gastro-oesophageal reflux for testing the efficacy of a new antireflux procedure, endoscopic gastroplasty, performed at flexible endoscopy without laparotomy or laparoscopy. METHODS: At endoscopy a pH sensitive radiotelemetry capsule was sewn to the oesophageal wall, 5 cm above the lower oesophageal sphincter, in six large white pigs. Ambulant pH recordings (48–96 hours; total 447 hours) were obtained. The median distal oesophageal pH was 6.8 (range 6.4–7.3); pH was less than 4 for 9.3% of the time. After one week, endoscopic gastroplasty was performed by placing sutures below the gastro-oesophageal junction, forming a neo-oesophagus of 1–2 cm in length. Postoperative manometry and pH recordings (24–96 hours; total 344 hours) were carried out. RESULTS: Following gastroplasty, the median sphincter pressure increased significantly from 3 to 6 mm Hg and in length from 3 to 3.75 cm. The median time pH was less than 4 decreased significantly from 9.3% to 0.2%. CONCLUSIONS: These are the first long term measurements of oesophageal pH in ambulant pigs. The finding of spontaneous reflux suggested a model for studying treatments of reflux. Endoscopic gastroplasty increased sphincter pressure and length and decreased acid reflux.