| Esophagogastric junction distensibility after fundoplication assessed with a novel functional luminal imaging probe. | |
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MedLine Citation:
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PMID: 19911238 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The aim of the study was to compare the esophagogastric junction (EGJ) compliance in response to controlled distension in fundoplication (FP) patients and controls using the functional luminal imaging probe (FLIP). BACKGROUND: FP aims to replicate normal EGJ distensibility. FLIP is a new technology that uses impedance planimetry to measure intraluminal cross-sectional area (CSA) during controlled distension. METHODS: Ten controls and ten FP patients were studied with high-resolution esophageal pressure topography (HREPT) and then the FLIP placed across the EGJ. Deglutitive and interdeglutitive EGJ distensibility was assessed with volume-controlled distension. The FLIP measured eight CSAs spaced 4 mm apart within a cylindrical saline-filled bag along with the corresponding intrabag pressure. RESULTS: The EGJ formed an hourglass shape during distensions with the central constriction at the diaphragmatic hiatus. The distensibility of the hiatus was significantly greater during deglutitive relaxation in both subject groups, but FP patients exhibited reduced EGJ distensibility and compliance compared to controls. During the interglutitive period, the corresponding increase in intrabag pressures at larger volumes were also greater in FP patients implying a longer segment of EGJ constriction. The EGJ distensibility characteristics did not correlate with HREPT measures. CONCLUSIONS: FLIP technology was used to compare EGJ distensibility in FP patients and control subjects. The least distensible locus within the EGJ was always at the hiatus. EGJ distensibility was significantly reduced, and the length of constriction increased in FP patients. Future FLIP studies will compare patients with and without post-FP dysphagia and gas bloat, symptoms suggestive of an overly restrictive FP. |
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Authors:
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Monika A Kwiatek; Kahrilas Kahrilas; Nathaniel J Soper; William J Bulsiewicz; Barry P McMahon; Hans Gregersen; John E Pandolfino |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract Volume: 14 ISSN: 1873-4626 ISO Abbreviation: J. Gastrointest. Surg. Publication Date: 2010 Feb |
Date Detail:
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Created Date: 2010-01-29 Completed Date: 2010-05-04 Revised Date: 2011-07-22 |
Medline Journal Info:
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Nlm Unique ID: 9706084 Medline TA: J Gastrointest Surg Country: United States |
Other Details:
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Languages: eng Pagination: 268-76 Citation Subset: IM |
Affiliation:
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Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611-2951, USA. monika.kwiatek@gmail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Anatomy, Cross-Sectional Compliance Diagnostic Techniques, Digestive System / instrumentation* Electric Impedance / diagnostic use Esophagogastric Junction / physiopathology* Female Fundoplication* Humans Male Manometry Middle Aged Postoperative Period Young Adult |
| Grant Support | |
ID/Acronym/Agency:
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R01 DC000646-09/DC/NIDCD NIH HHS; R01 DC00646/DC/NIDCD NIH HHS; R01 DK056033-08/DK/NIDDK NIH HHS |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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