Manometric study of the lower esophageal sphincter and esophagus in subtotal gastrectomy patients

Manometric study of the lower esophageal sphincter and esophagus in subtotal gastrectomy patients

Author Fonseca, C. A. Marcovechio Google Scholar
Martinez, J. C. Autor UNIFESP Google Scholar
Piesciotto, A. Google Scholar
Yanagita, E. T. Autor UNIFESP Google Scholar
Denardin, O. V. P. Google Scholar
Filho, B. Herani Autor UNIFESP Google Scholar
Institution Heliopolis Hosp
Universidade Federal de São Paulo (UNIFESP)
Abstract There is controversy in the literature regarding the motor function behavior of the lower esophageal sphincter and esophagus following partial gastrectomy. We studied 26 patients with gastric adenocarcinoma of the distal corpus and/or antrum who underwent radical subtotal gastrectomy with Roux-en-Y reconstruction. There were 15 women (57.69%) and 11 men (42.31%) with a mean age of 57.2 years; 21 were White (80.8%) and five were of African descent (19.2%). Before the surgery and 3 months afterwards, every patient underwent manometric and endoscopic examinations. the lower esophageal sphincter showed reductions in mean respiratory pressure (19.41-15.59 mmHg, P = 0.02) and maximum expiratory pressure (8.13-5.54 mmHg, P = 0.02) without significant alteration in diaphragmatic crura pressure (32.92-30.64 mmHg, P = 0.37). An increase in peristaltic wave amplitude (91.43-124.86 mmHg, P < 0.01) and peristaltic wave conduction velocity (3.29 cm/s to 4.23 cm/s; P = 0.024) were detected in esophageal function. the presence of erosive esophagitis decreased from 10 (38.46%) patients to none (P= 0.002). We concluded that following surgery the lower esophageal sphincter function was impaired, through decreased pressure in the esophageal component without alteration in diaphragmatic crura pressure. On the other hand, there was significant increase in peristaltic wave amplitude and velocity, and improvement of the erosive esophagitis. the authors suggest that subtotal gastrectomy, with gastroesophageal junction preservation, and Roux-en-Y reconstruction should be the preferred operation for distal gastric cancer to minimize esophageal dysfunction and gastroesophageal reflux disease.
Keywords esophageal sphincter
gastrectomy
manometry
stomach neoplasm
Language English
Date 2008-01-01
Published in Diseases of the Esophagus. Oxford: Blackwell Publishing, v. 21, n. 2, p. 118-124, 2008.
ISSN 1120-8694 (Sherpa/Romeo, impact factor)
Publisher Blackwell Publishing
Extent 118-124
Origin http://dx.doi.org/10.1111/j.1442-2050.2007.00734.x
Access rights Closed access
Type Article
Web of Science ID WOS:000252929600005
URI http://repositorio.unifesp.br/handle/11600/30343

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