Between 1984 and 1990, 22 patients with esophageal achalasia underwent Heller's esophagomyotomy plus Dor's partial funduplicatio using intraoperative esophageal manometry. In the same period 10 patients with gastroesophageal reflux disease underwent antireflux 'floppy' Nissen 360° funduplicatio with intraoperative manometric evaluation of the neo high-pressure zone. In 19 of the 22 patients with achalasia, at the end of the procedure, the intraoperative manometry showed residual pressure at the lower esophageal sphincter which called for additional myotomy. In all cases complete annulment of the lower esophageal sphincter activity was subsequently obtained. The clinical results were excellent in 18 cases and good in 4. In the 10 patients with gastroesophageal reflux disease the intraoperative manometric evaluation performed at the end of funduplicatio revealed, in all cases, a pressure value between 20 and 27 mmHg. This value was considered to be sufficient and no adjustment was considered necessary. Two patients suffered from transient postoperative dysphagia. One year after the operation one patient had a recurrence of the reflux. The Author's experience confirms that intraoperative manometry during Heller's esophagomyotomy for esophageal achalasia avoids the risks of incomplete myotomy and therefore can improve the results of this operation. In the 'floppy' Nissen 360° funduplicatio operation the Author's experience confirms that a standardized surgical technique is sufficient to obtain a satisfactory functional result and that the use of intraoperative manometry has no substantial effect on the results of the operation.
|Translated title of the contribution||Intraoperative manometry during functional surgery of the esophago-gastric junction|
|Number of pages||5|
|Publication status||Published - 1991|
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