Metabolic changes in the lower esophageal sphincter influencing the result of anti-reflux surgical interventions in chronic gastroesophageal reflux disease

doi:10.3748/wjg.v11.i11.1623

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Mar 21, 2005 (publication date) through Apr 25, 2024

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastroenterol. Mar 21, 2005; 11(11): 1623-1628
Published online Mar 21, 2005. doi: 10.3748/wjg.v11.i11.1623

Table 1 Metabolic enzyme activities and special protein concentrations in normal LES and in LES operated due to gastroesophageal reflux, as well as in patients with and without complaints in the postoperative period.

Enzymes	LES				P	LES in GERD				P
	Normal		GERD			Visick I		Visick II–III
	Mean	SE	Mean	SE		Mean	SE	Mean	SE
CK	73027.3	32312.4	398220.7	210587.2		P<0.05	111904.3	29131.0	1098105.3	514604.5	P<0.001
LDH	23805.7	9561.9	127786.9	62210.7	P<0.05	44229.0	7850.8	332039.5	54804.5	P<0.001
HBDH	7960.3	3159.9	41400.3	20129.8	P<0.05	13906.0	2588.4	105553.7	47629	P<0.001
AST	2869.5	1453.0	13397.2	6825.7	P<0.05	3697.0	923	36030.9	14938.4	P<0.001
CK-MB	269.1	103.9	1580.3	1332.6	NS	597.5	185.3	3655.2	4374.7	NS
S-100	1252.5	844	10569.1	5038.1	P<0.05	3986.5	2123.0	26018.5	11485.7	P<0.001
MYO	750.3	538.3	11339.8	14029.3	NS	2395.8	1268.1	32581.8	52349.6	P<0.05
TNI	0.17	0.08	1.56	0.78	P<0.05	0.68	0.24	3.93	2.25	P<0.001

LES: lower esophageal sphincter; GERD: gastroesophageal reflux disease; Visick I: symptom-free; Visick II-III: mild symptoms can be treated with medication; SE: standard error; P: significance; NS: non-significant; CK: creatine kinase; LDH: lactate dehydrogenase; HBDH: α-hydroxybutyrate dehydrogenase; AST: aspartate aminotransaminase; CK-MB: creatine kinase MB (U/g soluble protein); S-100; MYO: myoglobin; TNI: troponin I (μg/g wet weight).

Table 2 Lysosomal enzyme activities in normal LES and in LES operated due to gastroesophageal reflux, as well as in patients with and without complaints in the postoperative period.

Enzymes	LES				P	LES in GERD				P
	Normal		GERD			Visick I		Visick II–III
	Mean	SE	Mean	SE		Mean	SE	Mean	SE
CB	14177.5	3441.9	7727.6	1913.9		P<0.001	6442.8	2242.7	10439.8	3548.1	P<0.05
TPP I	74318.0	10742.6	47509.9	5339.3	P<0.001	47541.6	6760.4	47438.5	11067.2	NS
DPP II	3970.4	1189.3	2513.3	512	P<0.001	2860.7	647.1	1779.7	744.1	P<0.05
HEX	17253.7	4457.9	9185.0	1604.7	P<0.001	9528.2	2267.2	8460.4	2054.9	NS
GCU	17345.0	5145.4	13123.5	2307.5	NS	13980.1	3263.8	11315.2	2541.3	NS
BMAN	4207.5	1246.1	2922.9	587.7	P<0.05	3248.4	824.1	2235.9	481.4	NS
AMAN	962.4	726.8	469.9	172.2	NS	567.4	232.8	238.5	108.9	NS
BGAL	17714.3	3561.0	11396.7	1567.3	P<0.001	11733.9	2241.9	10684.9	1821.4	NS

LES: lower esophageal sphincter; GERD: gastroesophageal reflux disease; Visick I: symptom-free; Visick II–III: mild symptoms can be treated with medication; SE: standard error; P: significance; NS: non-significant; CB: cathepsin B; TPP I: tripeptidyl-peptidase I; DPP II: dipeptidyl-peptidase II; HEX: β-hexosaminidase B; GCU: β-glucuronidase; BMAN = β-mannosidase; AMAN: α-mannosidase; BGAL: β-galactosidase (pmoL/h·mg).

Table 3 Metabolic enzyme ratios in normal LES and in LES operated due to gastroesophageal reflux, as well as in patients with and without complaints in the postoperative period.

Enzymes	LES				P	LES in GERD				P
	Normal		GERD			Visick I		Visick II–III
	Mean	SE	Mean	SE		Mean	SE	Mean	SE
HBDH/LDH	0.337	0.009	0.319	0.006		P<0.001	0.321	0.009	0.318	0.008	NS
CK-MB/CK	0.005	0.003	0.006	0.003	NS	0.006	0.003	0.005	0.007	NS

LES: lower esophageal sphincter; GERD: gastroesophageal reflux disease; Visick I: symptom-free; Visick II–III: mild symptoms can be treated with medication; SE: standard error; P: significance; NS: non-significant; HBDH: α-hydroxybutyrate dehydrogenase; LDH: lactate dehydrogenase; CK-MB: creatine kinase MB; CK: creatine kinase.

Table 4 Patient satisfaction index according to Visick in the 2^nd and 12^th postoperative months of 31 patients who had laparoscopic floppy Nissen type operation due to gastroesophageal reflux disease.

Visick		2 (mo, %)			12 (mo, %)
I Symptoms-free	22 (71)			27(87)
II Mild symptoms	8 (26)	- Dysphagia	6/8	3 (10)	- Dysphagia	2/3
		- Bloating	3/8		- Bloating	2/3
		- Epigastric pain	2/8		Heartburn	1/3
III Can be treated with medication or with dilation	1 (3)	- Dysphagia		1 (3)	- Dysphagia
		- Heartburn			- Heartburn
		- Belching			- Belching
IV Reoperation needed		-			-

Citation: Altorjay A, Juhasz A, Kellner V, Sohar G, Fekete M, Sohar I. Metabolic changes in the lower esophageal sphincter influencing the result of anti-reflux surgical interventions in chronic gastroesophageal reflux disease. World J Gastroenterol 2005; 11(11): 1623-1628
URL: https://www.wjgnet.com/1007-9327/full/v11/i11/1623.htm
DOI: https://dx.doi.org/10.3748/wjg.v11.i11.1623