[Evaluation of esophageal function in surgically-treated patients]

Area of Science:

• Gastroenterology and Surgical Innovation
• Esophageal Motility Disorders
• Surgical Technique Optimization

Context:

• Functional esophageal diseases, including achalasia, diffuse esophageal spasm, diverticula, and gastroesophageal reflux, present complex surgical challenges.
• Previous surgical approaches have faced complications and failures, often due to imprecise procedural execution.
• Accurate preoperative functional assessment is vital for effective surgical planning.

Purpose:

• To highlight the indispensable role of intraoperative manometry (IEM) in refining surgical techniques for functional esophageal disorders.
• To demonstrate how IEM facilitates precise myotomy and calibrated Nissen fundoplication.
• To showcase the utility of instrumental probes and pH-metry in assessing and documenting surgical success.

Summary:

• The study details the authors' experience in surgically treating functional esophageal diseases, emphasizing the critical role of preoperative functional evaluation.
• Intraoperative manometry (IEM) is presented as a key tool to prevent incomplete myotomies and ensure accurate fundoplication (Nissen's).
• Postoperative assessment using instrumental probes and pH-metry confirms the effectiveness of IEM-guided surgery in resolving motor disorders and reflux.

Impact:

• Intraoperative manometry (IEM) significantly improves surgical precision, reducing complications and enhancing patient outcomes in functional esophageal disease treatment.
• Calibrated surgical interventions, guided by IEM, lead to documented resolution of preoperative symptoms and effective long-term reflux control.
• Advanced instrumental assessment post-surgery validates the efficacy of these refined surgical techniques, setting a higher standard for care.