Takahiro Masuda, Saurabh Singhal, Sreeja Biswas Roy, Michael Smith, Jasmine Huang, Sumeet K Mittal, Ross M Bremner. Norton Thoracic Institute; St. Joseph’s Hospital and Medical Center
INTRODUCTION: There is a high prevalence of esophageal dysmotility and pathological reflux in patients with advanced lung disease. Aim of this study is to understand the association of esophageal motility disorders and 24 Hr pH scores with underlying pulmonary disease.
METHODS AND PROCEDURES: All patients undergoing lung transplant at our institution are prospectively entered in a database. After IRB approval the database was queried to identify 100 patients who had pre-transplant esophageal HRM and 24 Hr pH study. Underlying pulmonary disease was classified using UNOS criteria. Two major groups were restrictive (RLD) and obstructive (OLD) lung disease. Esophageal manometry studies were reanalyzed using Chicago v 3.0 classification.
RESULTS: The 100 patients with complete esophageal studies underwent lung transplant between Jan 2014 to July 2015. Mean age was 60.8 ± 9.9 years with 36 females and a BMI of 26 ± 5.2. 58 patients had RLD and 39 patients had OLD. There was no difference in prevalence of esophageal motility disorders (60.3% vs 56.2%) and manometric hiatus hernia (31% vs 43.6%) between RLD and OLD groups. However, there was a significantly higher prevalence of pathological reflux between the groups: 45% vs 18% (p=0.004) between RLD and OLD. Gastric emptying study showed statistically no difference in prevalence of gastroparesis (6.3% vs 0%) between RLD and OLD.
CONCLUSIONS: There is significantly higher prevalence of pathological reflux disease in patients with RLD compared to OLD. This difference probably represents a fundamental difference in respiratory mechanistic derangement between RLD and OLD.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 80606
Program Number: P390
Presentation Session: Poster (Non CME)
Presentation Type: Poster