Může být peroperační manometrie jícnu využita v predikci dysfagie po antirefluxním výkonu?


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Title in English Could the Preoperative Manometry of the Oesophagus Be Used for Prediction of Dysphagia Following Antireflux procedures?


Year of publication 2005
Type Article in Periodical
Magazine / Source Rozhledy v chirurgii
MU Faculty or unit

Faculty of Informatics

Field Surgery incl. transplantology
Keywords reflux; fundoplication; laparoscopy; dysphagia; manometry
Description A possible development of the postoperative persisting dysphagia, which decreases the quality of life of the operated, remains the main drawback of the laparoscopis antireflux surgery. Among several variations of the antireflux surgical procedures, there si none completely eliminate this risk. In this study, supported by the IGA MZ ČR ND 7142-3 grant, peroperative measurements of the lower oesophageal sphincter (LES) tone with a concurrent callibration of the cuff using an oesophageal tube were taken. A complete Nissen-Rossetti cuff was applied in 39 patients. Peroperative increases in the LES tone following the completion of the antireflux cuffs were monitored. The patients continued to be monitored with the aim to detect the onset of dysphagia. In the patient group with the peroperative LES tone increase exceeding 15 mmHg, significantly higher rates of prolonged dysphagia were recorded. In cases of lower LES increases, the rates of dysphagia were low and good functioning to prevent any pathological gastrooesophageal reflux was maintained. No complication with respect to the peroperative oesophageal manometry was recorded. Duration of the antireflux operation conducted with the peroperative manometry was prologed by 4 minutes, on average. Based on the assessment of the data, the authors demonstrate that the LES tone increase on its own, does not provide for the antireflux of the fundoplication procedures and that patients cannot benefit form its extremely high values may indicate possible risks of dysphagia in the postoperative period.
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