Related Experiment Videos
[Studies on changes in low esophageal sphincter function after esophageal transection or esophago-esophagostomy in
M Uchiyama1, M Iwafuchi, Y Osawa
1Department of Pediatric Surgery, Niigata University Hospital, Japan.
Insights
Surgical treatments for pediatric esophageal issues can temporarily impact lower esophageal sphincter (LES) function. Esophageal transection showed early LES function decline, while esophago-esophagostomy maintained LES function, especially when stenosis was distant from the esophagogastric junction.
Area of Science:
- Pediatric surgery
- Gastrointestinal motility disorders
- Esophageal manometry
Context:
- Surgical interventions for esophageal varices and congenital stenosis in children require evaluation of esophageal function.
- Understanding post-operative esophageal motility is crucial for managing pediatric gastrointestinal conditions.
Purpose:
- To assess changes in esophageal function, specifically lower esophageal sphincter (LES) dynamics, following surgical treatments for esophageal varices or congenital stenosis in pediatric patients.
- To compare the impact of esophageal transection with paraesophageal devascularization versus esophago-esophagostomy with partial esophagectomy on LES pressure, length, relaxation, and gastroesophageal reflux.
Summary:
- Esophageal manometry in 16 children revealed that esophageal transection temporarily decreased LES pressure within 1 month, returning to baseline over 11 months, indicating early functional deterioration.
- Esophago-esophagostomy did not alter LES pressure or length. However, pre-existing or prolonged LES dysfunction was noted when congenital stenosis was near the esophagogastric junction.
- Postoperative LES dysfunction severity correlated with the proximity of surgical sites (transection or partial esophagectomy) to the esophagogastric junction.
Impact:
- Provides insights into the functional recovery of the esophagus after common pediatric surgical procedures.
- Informs surgical planning and patient management by highlighting factors influencing post-operative esophageal motility and potential for gastroesophageal reflux.
- Contributes to the understanding of long-term esophageal function in children following surgical correction of congenital or acquired esophageal abnormalities.
Abstract:
An aim of the present study is to clarify the changes of esophageal function after surgical treatments of the esophageal varices or the congenital esophageal stenosis in children. Esophageal manometric studies were performed in sixteen children undergoing the esophageal transection with paraesophageal devascularization or the esophago-esophagostomy with partial esophagectomy before, within 1 month and over 7 months after the operation. The pressure of lower esophageal sphincter (LES), the length of LES, the LES relaxation test and the gastroesophageal reflux (GER) inducing test were measured. 1) Esophageal transection; The pressure dropped within 1 month and returned to the preoperative level over 11 months after the operation. Temporal deterioration of LES function was observed during the early postoperative days. However, return to the preoperative state was gained over 1 year. 2) Esophago-esophagostomy; The pressure and the length of LES were not changed after the operation. The LES function was disturbed preoperatively and moreover long postoperatively, in the case when congenital stenosis closely existed to the esophago-gastric junction. Degree of the postoperative disturbance of the LES function may be influenced by the distance to the part of the transection or the partial esophagectomy from the E-C junction.