Intraoperative esophageal manometry and fundoplications: prospective study

Area of Science:

• Gastroenterology
• Surgical Innovation
• Diagnostic Tools

Background:

• Gastroesophageal reflux disease (GERD) management often involves surgical intervention.
• Assessing the effectiveness of surgical procedures like fundoplication is crucial for patient outcomes.
• Manometry is a key diagnostic tool in esophageal motility studies.

Purpose of the Study:

• To validate intraoperative manometry for assessing fundoplication.
• To identify manometric criteria that predict surgical success or complications.
• To evaluate the role of intraoperative measurements in managing GERD.

Main Methods:

• Prospective study of 48 patients undergoing fundoplication for GERD.
• Pre-, intra-, and postoperative manometry performed.
• Comparison of lower esophageal sphincter (LES) pressures and lengths before and after surgery.
• Analysis of manometric data in relation to postoperative outcomes like dysphagia and recurrence.

Main Results:

• Intraoperative LES pressure significantly increased after fundoplication compared to preoperative values.
• Postoperative LES pressure decreased by approximately 50% from intraoperative levels.
• Patients experiencing dysphagia showed a significantly greater relative increase in intraoperative LES pressure.
• The patient with recurrence had the lowest final intraoperative LES pressure.

Conclusions:

• Intraoperative manometry is a valuable tool for evaluating the lower esophageal sphincter during fundoplication.
• Manometric findings during surgery may predict the likelihood of dysphagia or recurrence.
• This technique could aid in optimizing surgical strategies for GERD.