Bravo~R oesophageal pH monitoring: should the capsule be implanted with upper GI endoscopy and sedation?

摘要

The Bravo~R oesophageal pH monitoring system uses a telemetric capsule and allows a recording to be made for a longer period under conditions which are physiologically closer to normal. The objective of this study was to use a retrospective series to assess whether the results were different according to the method employed to place the capsule. Oesophageal pH monitoring with the Bravo system was carried out in 145 patients. In 85 of these, the nasal or oral route was used without anaesthesia or endos-copy, while the remaining 60 patients had the capsule placed during gastroscopy performed under general anaesthetic. The oral route is better than the nasal, with a failure rate of 35% for the latter. The overall failure rate (failure of the procedure or a recording of less than 48 hours duration) or that associated with placement of the device was the same in both groups. A 48-hour trace was obtained in 123 patients (85%). The diagnostic benefit of the second 24 hours of this recording was 18%, with no significant difference between the two groups. The placement of the device can, therefore, be effected with or without gastroscopy. Results are similar and the choice of technique depends on local expertise and the indication for pH measurement.