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Sphincterlike thoracoabdominal high pressure zone after esophagogastrectomy
W A Klein1, H P Parkman, D T Dempsey
1Department of Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania.
Gastroenterology
|November 1, 1993
Summary
After surgery for esophageal removal, the crural diaphragm forms a high-pressure zone (HPZ) that helps prevent reflux. This study investigated its manometric characteristics in patients.
Area of Science:
- Gastroenterology
- Surgical anatomy
- Esophageal manometry
Background:
- The crural diaphragm's role in the gastroesophageal high-pressure zone (HPZ) is crucial for preventing gastroesophageal reflux.
- Investigating the manometric characteristics of the thoracoabdominal junction post-esophagectomy is important.
Purpose of the Study:
- To investigate the manometric characteristics of the thoracoabdominal junction in patients after surgical removal of the lower esophageal sphincter.
Main Methods:
- Esophageal manometry was performed on ten patients who had undergone esophagogastrectomy.
Main Results:
- A high-pressure zone (HPZ) and pressure inversion point were observed distal to the anastomosis in 90% of patients.
- The HPZ exhibited relaxation upon swallowing and contraction in response to increased intra-abdominal pressure.
- Breath holding inhibited the phasic pressure component of the HPZ.
Conclusions:
- A sphincter-like high-pressure zone (HPZ) exists at the thoracoabdominal junction following lower esophageal sphincter removal.
- The crural diaphragm is suggested to be responsible for this post-surgical HPZ.