Restoration of normal distensive characteristics of the esophagogastric junction after fundoplication.

Abstract:

OBJECTIVE:To study the mechanical characteristics of the esophagogastric junction (EGJ) of postfundoplication patients and compare them with previously reported data on normal subjects and GERD patients. METHODS:Eight normal subjects, 9 GERD patients, and 8 fundoplication patients were studied with concurrent manometry, fluoroscopy, and stepwise controlled barostat distention of the EGJ. The minimal barostat pressure required to open the EGJ during the interswallow period was determined. Thereafter, barium swallows were imaged in 5-mm Hg increments of intrabag pressure. EGJ diameter and length were measured at each pressure during deglutitive relaxation. RESULTS:EGJ opening diameter during deglutitive relaxation was on average 0.5 cm greater in GERD patients compared with normal subjects and fundoplication patients (P < 0.05). EGJ opening pressure and opening diameter were comparable between normal subjects and fundoplication patients; however, the EGJ length was 32% longer in fundoplication patients. CONCLUSIONS:Fundoplication restores distensibility of the EGJ to a level similar to normal subjects. Since trans-EGJ flow is related to EGJ length and EGJ diameter, these findings suggest that retrograde flow through the EGJ would be decreased by both a reduction in diameter and an increase in length of the EGJ.

journal_name

Ann Surg

journal_title

Annals of surgery

authors

Pandolfino JE,Curry J,Shi G,Joehl RJ,Brasseur JG,Kahrilas PJ

doi

10.1097/01.sla.0000167868.44211.f0

subject

Has Abstract

pub_date

2005-07-01 00:00:00

pages

43-8

issue

1

eissn

0003-4932

issn

1528-1140

pii

00000658-200507000-00007

journal_volume

242

pub_type

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