Document Detail


Restoration of normal distensive characteristics of the esophagogastric junction after fundoplication.
MedLine Citation:
PMID:  15973100     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
John E Pandolfino; Jennifer Curry; Guoxiang Shi; Raymond J Joehl; James G Brasseur; Peter J Kahrilas
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Annals of surgery     Volume:  242     ISSN:  0003-4932     ISO Abbreviation:  Ann. Surg.     Publication Date:  2005 Jul 
Date Detail:
Created Date:  2005-06-23     Completed Date:  2005-08-04     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0372354     Medline TA:  Ann Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  43-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Northwestern University Medical School, Chicago, IL, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Case-Control Studies
Endoscopy, Gastrointestinal / methods
Esophagogastric Junction / physiopathology,  surgery*
Female
Follow-Up Studies
Fundoplication / methods*
Gastroesophageal Reflux / diagnosis,  surgery*
Hernia, Hiatal / diagnosis,  surgery*
Humans
Male
Manometry
Middle Aged
Postoperative Complications
Recovery of Function
Reference Values
Risk Assessment
Severity of Illness Index
Treatment Outcome
Grant Support
ID/Acronym/Agency:
K23 DK062170-01/DK/NIDDK NIH HHS; R01 DC00646/DC/NIDCD NIH HHS
Comments/Corrections
Comment In:
Ann Surg. 2006 Feb;243(2):288; author reply 288-9   [PMID:  16432367 ]

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