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Erschienen in: Obesity Surgery 10/2008

01.10.2008 | Research Article

Gastroesophageal Reflux Disease in Morbid Obesity: The Effect of Roux-en-Y Gastric Bypass

verfasst von: Mariel A. Mejía-Rivas, Alejandro Herrera-López, Jorge Hernández-Calleros, Miguel F. Herrera, Miguel A. Valdovinos

Erschienen in: Obesity Surgery | Ausgabe 10/2008

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Abstract

Background

Gastroesophageal reflux disease (GERD) is a common condition in obesity. The impact of Roux-en-Y gastric bypass (RYGBP) on GERD is poorly known. We studied the effect of the RYGBP on GERD in patients with morbid obesity (MO).

Methods

Twenty consecutive patients with MO (BMI > 40 kg/m2) were studied before and 6 months after RYGBP. GERD symptoms were evaluated with Carlsson–Dent questionnaire (CDQ). All the patients underwent esophageal manometry and ambulatory 24-h pH-metry. Chi-square test was used to compare categorical variables, and Wilcoxon test was used for numerical variables. A p value under 0.05 was considered significant.

Results

There were 16 women (80%) and 4 men (20%) with mean age 38.9 ± 6.9 years included in this study. BMI was 48.5 ± 6.2 kg/m2 and 33.2 ± 4.5 kg/m2 before and after RYGBP, respectively. Mean weight reduction was 42.5 ± 9.7 kg (p < 0.001). Reflux symptoms measured by CDQ and esophageal acid exposure improved significantly after RYGBP. The percentage of time of pH < 4 was 10.7 ± 6.7 before and 1.6 ± 1.2 after the surgical procedure (p < 0.001). LES basal pressure before and after the RYGBP was 18 ± 11 and 20.1 ± 5.6 mmHg (p = 0.372), and the esophageal body amplitude was 104.2 ± 47.2 and 75.1 ± 36.2 mmHg, respectively (p = 0.005).

Conclusion

RYGBP improves GERD symptoms and reduces esophageal acid exposure in patients with MO.
Literatur
1.
Zurück zum Zitat Sánchez C, Pichardo E, López P. Prevalencia de la obesidad. Gac Med Mex. 2004;140:S3–20. Sánchez C, Pichardo E, López P. Prevalencia de la obesidad. Gac Med Mex. 2004;140:S3–20.
2.
Zurück zum Zitat Must A, Spadano J, et al. The disease burden associated with overweight and obesity. JAMA. 1999;282:1530–8.CrossRef Must A, Spadano J, et al. The disease burden associated with overweight and obesity. JAMA. 1999;282:1530–8.CrossRef
3.
Zurück zum Zitat Lundell L, Ruth M, et al. Does massive obesity promote abnormal gastro-esophageal reflux? Dig Dis Sci. 1995;40:1632–5.PubMedCrossRef Lundell L, Ruth M, et al. Does massive obesity promote abnormal gastro-esophageal reflux? Dig Dis Sci. 1995;40:1632–5.PubMedCrossRef
4.
Zurück zum Zitat Fisher BL, Pennathru A, et al. Obesity correlates with gastroesophageal reflux. Dig Dis Sci. 1999;44:2290–4.PubMedCrossRef Fisher BL, Pennathru A, et al. Obesity correlates with gastroesophageal reflux. Dig Dis Sci. 1999;44:2290–4.PubMedCrossRef
5.
Zurück zum Zitat Gómez Escudero O, Herrera Hernández M, Valdovinos Díaz MA. Obesidad y enfermedad por reflujo gastroesófagico. Rev Invest Clin. 2002;54(4):320–7.PubMed Gómez Escudero O, Herrera Hernández M, Valdovinos Díaz MA. Obesidad y enfermedad por reflujo gastroesófagico. Rev Invest Clin. 2002;54(4):320–7.PubMed
6.
Zurück zum Zitat Hagen J, Deitel M, Khanna RK, et al. Gastroesophageal reflux in the massively obese. Int Surg. 1987;72:1–3.PubMed Hagen J, Deitel M, Khanna RK, et al. Gastroesophageal reflux in the massively obese. Int Surg. 1987;72:1–3.PubMed
7.
Zurück zum Zitat Rigaud D, Merrouche M, Le Möel G, et al. Factors of gastroesophageal acid reflux in severe obesity. Gastroenterol Clin Biol. 1995;19:818–25.PubMed Rigaud D, Merrouche M, Le Möel G, et al. Factors of gastroesophageal acid reflux in severe obesity. Gastroenterol Clin Biol. 1995;19:818–25.PubMed
8.
Zurück zum Zitat Wajed SA, Streets CG, Bremmer CG, et al. Elevated body mass disrupts the barrier to gastroesophageal reflux. Arch Surg. 2001;136:1014–9.PubMedCrossRef Wajed SA, Streets CG, Bremmer CG, et al. Elevated body mass disrupts the barrier to gastroesophageal reflux. Arch Surg. 2001;136:1014–9.PubMedCrossRef
9.
Zurück zum Zitat Merced CD, Wren SF, DaCosta LR, et al. Lower esophageal sphincter pressure gradients in excessively obese patients. J Med. 1987;18:135–46. Merced CD, Wren SF, DaCosta LR, et al. Lower esophageal sphincter pressure gradients in excessively obese patients. J Med. 1987;18:135–46.
10.
11.
Zurück zum Zitat Quiroga E, Cuenca-Abente F, Flum D, et al. Impaired esophageal function in morbidly obese patients with gastroesophageal reflux disease: evaluation with multichannel intraluminal impedance. Surg Endosc. 2006;20(5):739–43.PubMedCrossRef Quiroga E, Cuenca-Abente F, Flum D, et al. Impaired esophageal function in morbidly obese patients with gastroesophageal reflux disease: evaluation with multichannel intraluminal impedance. Surg Endosc. 2006;20(5):739–43.PubMedCrossRef
12.
Zurück zum Zitat Jaffin BW, Knoepflmacher P, et al. High prevalence of asymptomatic esophageal motility disorders among morbidly obese patients. Obes Surg. 1999;9:390–5.PubMedCrossRef Jaffin BW, Knoepflmacher P, et al. High prevalence of asymptomatic esophageal motility disorders among morbidly obese patients. Obes Surg. 1999;9:390–5.PubMedCrossRef
13.
Zurück zum Zitat Hong D, Yashodhan S, et al. Manometric abnormalities and gastro-esophageal reflux disease in the morbidly obese. Obes Surg. 2004;14:744–9.PubMedCrossRef Hong D, Yashodhan S, et al. Manometric abnormalities and gastro-esophageal reflux disease in the morbidly obese. Obes Surg. 2004;14:744–9.PubMedCrossRef
14.
Zurück zum Zitat Suter M, Dorta G, et al. Gastro-esophageal reflux disease and esophageal motility disorders in morbidly obese patients. Obes Surg. 2004;14:959–66.PubMedCrossRef Suter M, Dorta G, et al. Gastro-esophageal reflux disease and esophageal motility disorders in morbidly obese patients. Obes Surg. 2004;14:959–66.PubMedCrossRef
15.
Zurück zum Zitat Di Francesco V, Baggio E, Mastrmauro M, et al. Obesity and gastroesophageal acid reflux: physiopathological mechanisms and role of bariatric surgery. Obes Surg. 2004;14(8):1095–02.CrossRef Di Francesco V, Baggio E, Mastrmauro M, et al. Obesity and gastroesophageal acid reflux: physiopathological mechanisms and role of bariatric surgery. Obes Surg. 2004;14(8):1095–02.CrossRef
16.
Zurück zum Zitat Weiss HG, Nehoda H, et al. Treatment or morbid obesity with laparoscopic adjustable gastric banding affects esophageal motility. Am J Surg. 2000;180:479–82.PubMedCrossRef Weiss HG, Nehoda H, et al. Treatment or morbid obesity with laparoscopic adjustable gastric banding affects esophageal motility. Am J Surg. 2000;180:479–82.PubMedCrossRef
17.
Zurück zum Zitat Suter M, Dorta G, et al. Gastric banding interferes with esophageal motility and gastroesophageal reflux. Arch Surg. 2005;140(7):639–43.PubMedCrossRef Suter M, Dorta G, et al. Gastric banding interferes with esophageal motility and gastroesophageal reflux. Arch Surg. 2005;140(7):639–43.PubMedCrossRef
18.
Zurück zum Zitat Klaus A, Gruber I, Wetscher G, et al. Prevalent esophageal body motility disorders underlie aggravation of GERD symptoms in morbidly obese patients following adjustable gastric banding. Arch Surg. 2006;141(3):247–51.PubMedCrossRef Klaus A, Gruber I, Wetscher G, et al. Prevalent esophageal body motility disorders underlie aggravation of GERD symptoms in morbidly obese patients following adjustable gastric banding. Arch Surg. 2006;141(3):247–51.PubMedCrossRef
19.
Zurück zum Zitat Ovrebo KK, Hatlebakk JG, Viste A, et al. Gastroesophageal reflux in morbidly obese patients treated with gastric banding or vertical banded gastroplasty. Ann Surg. 1998;228(1):51–8.PubMedCrossRef Ovrebo KK, Hatlebakk JG, Viste A, et al. Gastroesophageal reflux in morbidly obese patients treated with gastric banding or vertical banded gastroplasty. Ann Surg. 1998;228(1):51–8.PubMedCrossRef
20.
Zurück zum Zitat Balduyck B, Vansteenkiste S, Ruppert M, et al. The evaluation of pyrosis and long-term satisfaction after gastric restrictive procedures: a retrospective study. Acta Chir Belg. 2005;105(2):161–7.PubMed Balduyck B, Vansteenkiste S, Ruppert M, et al. The evaluation of pyrosis and long-term satisfaction after gastric restrictive procedures: a retrospective study. Acta Chir Belg. 2005;105(2):161–7.PubMed
21.
Zurück zum Zitat Lundell L, Ruth M, Olbe L. Vertical banded gastroplasty or gastric banding for morbid obesity: effects on gastro-esophageal reflux. Eur J Surg. 1997;163(7):525–31.PubMed Lundell L, Ruth M, Olbe L. Vertical banded gastroplasty or gastric banding for morbid obesity: effects on gastro-esophageal reflux. Eur J Surg. 1997;163(7):525–31.PubMed
22.
Zurück zum Zitat Naslund E, Granstrom L, Melcher A, et al. Gastro-oesophageal reflux before and after vertical banded gastroplasty in the treatment of obesity. Eur J Surg. 1996;162:303–6.PubMed Naslund E, Granstrom L, Melcher A, et al. Gastro-oesophageal reflux before and after vertical banded gastroplasty in the treatment of obesity. Eur J Surg. 1996;162:303–6.PubMed
23.
Zurück zum Zitat Deitel M, Khanna RK, Hagen J, et al. Vertical banded gastroplasty as an antireflux procedure. Am J Surg. 1998;155:512–6.CrossRef Deitel M, Khanna RK, Hagen J, et al. Vertical banded gastroplasty as an antireflux procedure. Am J Surg. 1998;155:512–6.CrossRef
24.
Zurück zum Zitat Smith SC, Edwards CB, et al. Symptomatic and clinical improvement in morbidly obese patients with gastro-esophageal reflux disease following Roux-en-Y gastric bypass. Obes Surg. 1997;7:479–84.PubMedCrossRef Smith SC, Edwards CB, et al. Symptomatic and clinical improvement in morbidly obese patients with gastro-esophageal reflux disease following Roux-en-Y gastric bypass. Obes Surg. 1997;7:479–84.PubMedCrossRef
25.
Zurück zum Zitat Foster A, Laws HL, Gonzalez QH, et al. Gastrointestinal symptomatic outcome after laparoscopic Roux-en-Y gastric bypass. J Gastrointest Surg. 2003;7(6):750–3.PubMedCrossRef Foster A, Laws HL, Gonzalez QH, et al. Gastrointestinal symptomatic outcome after laparoscopic Roux-en-Y gastric bypass. J Gastrointest Surg. 2003;7(6):750–3.PubMedCrossRef
26.
Zurück zum Zitat Heading RC. Epidemiology of esophageal reflux disease. Scand J Gastroenterol. 1989;168 Suppl:S33–7. Heading RC. Epidemiology of esophageal reflux disease. Scand J Gastroenterol. 1989;168 Suppl:S33–7.
27.
Zurück zum Zitat Frase-Moodie CA, Norton B, Gorall C, et al. Weight loss has an independent beneficial effect on symptoms of gastro-esophageal reflux in patients who are overweight. Scand J Gastroenterol. 1999;34:337–40.CrossRef Frase-Moodie CA, Norton B, Gorall C, et al. Weight loss has an independent beneficial effect on symptoms of gastro-esophageal reflux in patients who are overweight. Scand J Gastroenterol. 1999;34:337–40.CrossRef
28.
Zurück zum Zitat Mathus-Vliegen LM, Tytgat GN. Twenty-four-hour pH measurements in morbid obesity: effects of massive overweight, weight loss and gastric distension. Eur J Gastroenterol Hepatol. 1996;8:625–6. Mathus-Vliegen LM, Tytgat GN. Twenty-four-hour pH measurements in morbid obesity: effects of massive overweight, weight loss and gastric distension. Eur J Gastroenterol Hepatol. 1996;8:625–6.
29.
Zurück zum Zitat Frezza EE, Ikramuddin S, Gourash W, et al. Symptomatic improvement in gastroesophageal reflux disease following laparoscopic Roux-en-Y gastric bypass. Surg Endosc. 2002;16:1027–31.PubMedCrossRef Frezza EE, Ikramuddin S, Gourash W, et al. Symptomatic improvement in gastroesophageal reflux disease following laparoscopic Roux-en-Y gastric bypass. Surg Endosc. 2002;16:1027–31.PubMedCrossRef
30.
Zurück zum Zitat Ortega J, Escudero MD, Mora F, et al. Outcome of esophageal function and 24-hour esophageal pH monitoring after vertical banded gastroplasty and Roux-en-Y gastric bypass. Obes Surg. 2004;14:1086–94.PubMedCrossRef Ortega J, Escudero MD, Mora F, et al. Outcome of esophageal function and 24-hour esophageal pH monitoring after vertical banded gastroplasty and Roux-en-Y gastric bypass. Obes Surg. 2004;14:1086–94.PubMedCrossRef
31.
Zurück zum Zitat Balsiger BM, Murr MM, Mai J, et al. Gastroesophageal reflux after intact vertical banded gastroplasty: correction by conversion to Roux-en Y gastric bypass. J Gastrointest Surg. 2000;4:276–81.PubMedCrossRef Balsiger BM, Murr MM, Mai J, et al. Gastroesophageal reflux after intact vertical banded gastroplasty: correction by conversion to Roux-en Y gastric bypass. J Gastrointest Surg. 2000;4:276–81.PubMedCrossRef
32.
Zurück zum Zitat Kim CH, Sarr MG. Severe reflux esophagitis after vertical banded gastroplasty for treatment of morbid obesity. Mayo Clin Proc. 1992;67:33–5.PubMed Kim CH, Sarr MG. Severe reflux esophagitis after vertical banded gastroplasty for treatment of morbid obesity. Mayo Clin Proc. 1992;67:33–5.PubMed
33.
Zurück zum Zitat Bloomberg RD, Urbach DR. Laparoscopic Roux-en-Y gastric bypass for severe gastroesophageal reflux after vertical banded gastroplasty. Obes Surg. 2002;12:408–11.PubMedCrossRef Bloomberg RD, Urbach DR. Laparoscopic Roux-en-Y gastric bypass for severe gastroesophageal reflux after vertical banded gastroplasty. Obes Surg. 2002;12:408–11.PubMedCrossRef
34.
Zurück zum Zitat Perry Y, Courcoulas AP, Fernando HC, et al. Laparoscopic Roux-en-Y gastric bypass for recalcitrant gastroesophageal reflux disease in morbidly obese patients. JSLS. 2004;8(1):19–23.PubMed Perry Y, Courcoulas AP, Fernando HC, et al. Laparoscopic Roux-en-Y gastric bypass for recalcitrant gastroesophageal reflux disease in morbidly obese patients. JSLS. 2004;8(1):19–23.PubMed
35.
Zurück zum Zitat Jones KB Jr, Allen TV, Manas KJ, et al. Roux-en-Y gastric bypass: an effective anti-reflux procedure. Obes Surg. 1991;1:295–8.PubMedCrossRef Jones KB Jr, Allen TV, Manas KJ, et al. Roux-en-Y gastric bypass: an effective anti-reflux procedure. Obes Surg. 1991;1:295–8.PubMedCrossRef
36.
Zurück zum Zitat Clements RH, Gonzalez QH, Foster A, et al. Gastrointestinal symptoms are more intense in morbidly obese patients and are improved with laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2003;13(4):610–4.PubMedCrossRef Clements RH, Gonzalez QH, Foster A, et al. Gastrointestinal symptoms are more intense in morbidly obese patients and are improved with laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2003;13(4):610–4.PubMedCrossRef
37.
Zurück zum Zitat Jones KB Jr. Roux-en-Y gastric bypass: an effective anti-reflux procedure in the less than morbidly obese. Obes Surg. 1998;8:35–8.PubMedCrossRef Jones KB Jr. Roux-en-Y gastric bypass: an effective anti-reflux procedure in the less than morbidly obese. Obes Surg. 1998;8:35–8.PubMedCrossRef
38.
Zurück zum Zitat Patterson EJ, Khajanchee YS, Swanstrom LL, et al. Objective assessment of the effect of laparoscopic gastric bypass on esophageal pH and motility in morbidly obese patients with GERD. Obes Surg. 2001;11:408 (abst 102). Patterson EJ, Khajanchee YS, Swanstrom LL, et al. Objective assessment of the effect of laparoscopic gastric bypass on esophageal pH and motility in morbidly obese patients with GERD. Obes Surg. 2001;11:408 (abst 102).
39.
Zurück zum Zitat Jong JR, Ramshorts B, Timmer R, et al. Effect of laparoscopic gastric banding on esophageal motility. Obes Surg. 2006;16:52–8.PubMedCrossRef Jong JR, Ramshorts B, Timmer R, et al. Effect of laparoscopic gastric banding on esophageal motility. Obes Surg. 2006;16:52–8.PubMedCrossRef
40.
Zurück zum Zitat Tolonen P, Victorzon M, Niemi R, et al. Does gastric banding for obesity reduce or increase gastroesophageal reflux? Obes Surg. 2006;16:1469–74.PubMedCrossRef Tolonen P, Victorzon M, Niemi R, et al. Does gastric banding for obesity reduce or increase gastroesophageal reflux? Obes Surg. 2006;16:1469–74.PubMedCrossRef
41.
Zurück zum Zitat Stene-Larsen G, Weberg R, Froyshov-Larsen I, et al. Relationship of overweight to hiatus hernia and reflux esophagitis. Scand J Gastroenterol. 1988;23:427–32.PubMedCrossRef Stene-Larsen G, Weberg R, Froyshov-Larsen I, et al. Relationship of overweight to hiatus hernia and reflux esophagitis. Scand J Gastroenterol. 1988;23:427–32.PubMedCrossRef
42.
Zurück zum Zitat Kahrilas P, Shi G, Manka M, et al. Increased frequency of transient lower esophageal sphincter relaxation induced by gastric distention in reflux patients with hiatus hernia. Gastroenterol. 2000;118:688–95.CrossRef Kahrilas P, Shi G, Manka M, et al. Increased frequency of transient lower esophageal sphincter relaxation induced by gastric distention in reflux patients with hiatus hernia. Gastroenterol. 2000;118:688–95.CrossRef
43.
Zurück zum Zitat Kahrilas P, Wu S, Lin SH. Attenuation of esophageal shortening during peristalsis with hiatus hernia. Gastroenterol. 1995;109:1818–25.CrossRef Kahrilas P, Wu S, Lin SH. Attenuation of esophageal shortening during peristalsis with hiatus hernia. Gastroenterol. 1995;109:1818–25.CrossRef
44.
Zurück zum Zitat Sloan SH, Kahrilas P. Impairment of esophageal emptying with hiatus hernia. Gastroenterol. 1991;100:596–605. Sloan SH, Kahrilas P. Impairment of esophageal emptying with hiatus hernia. Gastroenterol. 1991;100:596–605.
45.
Zurück zum Zitat Maddox A, Horowitz M, Wishart J, et al. Gastric and esophageal emptying in obesity. Scand J Gastroenterol. 1989;24:593–8.PubMedCrossRef Maddox A, Horowitz M, Wishart J, et al. Gastric and esophageal emptying in obesity. Scand J Gastroenterol. 1989;24:593–8.PubMedCrossRef
46.
Zurück zum Zitat Merced CD, Rue C, Hanelin L, et al. Effect of obesity on esophageal transit. Am J Surg. 1985;149:177–81.CrossRef Merced CD, Rue C, Hanelin L, et al. Effect of obesity on esophageal transit. Am J Surg. 1985;149:177–81.CrossRef
47.
Zurück zum Zitat Smith CD, Herkes SB, Behrm KE. Gastric acid secretion and vitamin B 12 absorption after vertical Roux en-Y gastric bypass for morbid obesity. Ann Surg. 1993;218:91–9.PubMedCrossRef Smith CD, Herkes SB, Behrm KE. Gastric acid secretion and vitamin B 12 absorption after vertical Roux en-Y gastric bypass for morbid obesity. Ann Surg. 1993;218:91–9.PubMedCrossRef
48.
Zurück zum Zitat Achem S, Kolts B, Wears R, et al. Chest pain associated with nutcracker esophagus: a preliminary study of the role of gastroesophageal reflux. Am J Gastroenterol. 1993;88(2):187–92.PubMed Achem S, Kolts B, Wears R, et al. Chest pain associated with nutcracker esophagus: a preliminary study of the role of gastroesophageal reflux. Am J Gastroenterol. 1993;88(2):187–92.PubMed
49.
Zurück zum Zitat Vinjirayer E, González B, Brensinger C, et al. Ineffective motility is not a marker for gastroesophageal reflux disease. Am J Gastroenterol. 2003;98:771–6.PubMedCrossRef Vinjirayer E, González B, Brensinger C, et al. Ineffective motility is not a marker for gastroesophageal reflux disease. Am J Gastroenterol. 2003;98:771–6.PubMedCrossRef
50.
Zurück zum Zitat Leite L, Johnston B, Barrett J, et al. Ineffective esophageal motility. The primary finding in patients with nonspecific esophageal motility disorder. Dig Dis Sci. 1997;42(9):1859–65.PubMedCrossRef Leite L, Johnston B, Barrett J, et al. Ineffective esophageal motility. The primary finding in patients with nonspecific esophageal motility disorder. Dig Dis Sci. 1997;42(9):1859–65.PubMedCrossRef
51.
Zurück zum Zitat Simrén M, Silny J, Holloway R, et al. Relevance of ineffective oesophageal motility during oesophageal acid clearance. Gut. 2003;52:784–90.PubMedCrossRef Simrén M, Silny J, Holloway R, et al. Relevance of ineffective oesophageal motility during oesophageal acid clearance. Gut. 2003;52:784–90.PubMedCrossRef
52.
Zurück zum Zitat Ho SH, Chang CH, Wu Ch. Ineffective esophageal motility is a primary motility disorder in gastroesophageal reflux disease. Dig Dis Sci. 2000;47(3):652–6.CrossRef Ho SH, Chang CH, Wu Ch. Ineffective esophageal motility is a primary motility disorder in gastroesophageal reflux disease. Dig Dis Sci. 2000;47(3):652–6.CrossRef
53.
Zurück zum Zitat Kim SH, Lee SH, Im HH, et al. The relationship between ineffective esophageal motility and gastro-esophageal reflux disease. Korean J Gastroenterol. 2005;46(4):255–61.PubMed Kim SH, Lee SH, Im HH, et al. The relationship between ineffective esophageal motility and gastro-esophageal reflux disease. Korean J Gastroenterol. 2005;46(4):255–61.PubMed
Metadaten
Titel
Gastroesophageal Reflux Disease in Morbid Obesity: The Effect of Roux-en-Y Gastric Bypass
verfasst von
Mariel A. Mejía-Rivas
Alejandro Herrera-López
Jorge Hernández-Calleros
Miguel F. Herrera
Miguel A. Valdovinos
Publikationsdatum
01.10.2008
Verlag
Springer-Verlag
Erschienen in
Obesity Surgery / Ausgabe 10/2008
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-008-9474-2

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