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Related Experiment Videos

Intraoperative esophageal manometry: is it valid?

M B Orringer, R Schneider, G W Williams

    The Annals of Thoracic Surgery
    |July 1, 1980
    PubMed
    Summary
    This summary is machine-generated.

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    Neuropharmacology·2011

    Intraoperative esophageal high-pressure zone (HPZ) measurements during Collis-Nissen antireflux surgery are unreliable predictors of long-term outcomes. Postoperative reflux was absent in all patients, regardless of intraoperative HPZ values.

    Area of Science:

    • Gastroenterology
    • Surgical Procedures
    • Esophageal Physiology

    Background:

    • The Collis-Nissen antireflux operation is a surgical procedure to treat gastroesophageal reflux disease.
    • High-pressure zone (HPZ) measurements in the distal esophagus are used to assess esophageal function.
    • Intraoperative HPZ values may be influenced by surgical manipulation.

    Purpose of the Study:

    • To evaluate the reliability of intraoperative distal esophageal high-pressure zone (HPZ) measurements as predictors of postoperative outcomes after Collis-Nissen antireflux surgery.
    • To determine the correlation between intraoperative HPZ values and long-term postoperative HPZ measurements and reflux status.

    Main Methods:

    • Prospective study involving 45 patients undergoing Collis-Nissen antireflux operation.

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  • Preoperative, intraoperative, and postoperative distal esophageal HPZ measurements were recorded.
  • Esophageal acid reflux testing was performed at 6 to 12 months postoperatively.

    • Main Results:

    • Intraoperative esophageal manipulation significantly affected HPZ in 24% of patients.
    • Mean intraoperative HPZ pressure (21.2 mm Hg) was significantly higher than postoperative values at 1-3 weeks (15.2 mm Hg), 6 months (11.2 mm Hg), and 12 months (12.1 mm Hg).
    • No significant correlation was found between final intraoperative HPZ and late postoperative HPZ values (6 and 12 months).
    • All patients were free of gastroesophageal reflux at 6 to 12 months, irrespective of intraoperative HPZ.

    Conclusions:

    • Intraoperative HPZ values obtained during Collis-Nissen antireflux surgery are variable and not reliable predictors of long-term postoperative HPZ.
    • The clinical rationale for modifying surgical techniques based solely on achieving an 'ideal' intraoperative HPZ value should be questioned.
    • Successful antireflux outcomes, as assessed by acid reflux testing, were achieved in all patients regardless of intraoperative HPZ measurements.