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Physiologic consequences of pneumonectomy. Consequences on the esophageal function.
H C Suen1, H Hendrix, G A Patterson
1Division of Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.
Chest Surgery Clinics of North America
|June 12, 1999
Summary
Pneumonectomy can cause esophageal and upper gastrointestinal dysmotility due to nerve injury and scarring. Surgeons should minimize direct esophageal and vagal nerve damage during procedures to reduce these complications.
Area of Science:
- Thoracic surgery
- Gastroenterology
- Surgical complications
Background:
- Esophageal and upper gastrointestinal dysmotility are recognized complications following pneumonectomy.
- These issues occur both after pneumonectomy without pulmonary replacement and in recipients undergoing thoracic organ transplantation.
Purpose of the Study:
- To summarize the occurrence and potential causes of esophageal and upper gastrointestinal dysmotility after pneumonectomy.
- To highlight the importance of surgical technique in preventing these postoperative complications.
Main Methods:
- Review of clinical outcomes and surgical factors associated with pneumonectomy.
- Analysis of potential etiological mechanisms for post-pneumonectomy gastrointestinal dysmotility.
Main Results:
- Pneumonectomy without pulmonary replacement leads to esophageal displacement and peristaltic disturbances.
- Thoracic organ transplantation recipients frequently experience esophageal dysmotility and delayed gastric emptying.
- Identified causes include vagal nerve injury, ischemia, scarring, and autonomic nervous system disruption.
Conclusions:
- Esophageal dysmotility is a significant consequence of pneumonectomy.
- Preventing direct injury to the esophagus and vagal nerves during surgery is crucial for mitigating these adverse effects.