scholarly journals PREOPERATIVE MANOMETRY FOR THE SELECTION OF OBESE PEOPLE CANDIDATE TO SLEEVE GASTRECTOMY

2017 ◽  
Vol 30 (3) ◽  
pp. 222-224 ◽  
Author(s):  
Antonio Carlos VALEZI ◽  
Fernando Augusto HERBELLA ◽  
Jorge MALI-JUNIOR ◽  
Mariano de Almeida MENEZES ◽  
Mário LIBERATTI ◽  
...  
Keyword(s):  
Sleeve Gastrectomy ◽  
Lower Esophageal Sphincter ◽  
Wave Amplitude ◽  
Lower Esophageal Sphincter Pressure ◽  
Sphincter Pressure ◽  
Esophageal Peristalsis ◽  
Before And After ◽  
Esophageal Sphincter ◽  
One Year ◽  
Contraction Wave

ABSTRACT Background: Sleeve gastrectomy may alter esophageal motility and lower esophageal sphincter pressure. Aim: To detect manometric changings in the esophagus and lower esophageal sphincter before and after sleeve gastrectomy in order to select patients who could develop postoperative esophageal motilitity disorders and lower esophageal sphincter pressure modifications. Methods: Seventy-three patients were selected. All were submitted to manometry before the operation and one year after. The variables analyzed were: resting pressure of the lower esophageal sphincter, contraction wave amplitude, duration of contraction waves, and esophageal peristalsis. Data were compared before and after surgery and to the healthy and non-obese control group. Exclusion criteria were: previous gastric surgery, reflux symptoms or endoscopic findings of reflux or hiatal hernia, diabetes and use of medications that could affect esophageal or lower esophageal sphincter motility. Results: 49% of the patients presented preoperative manometric alterations: lower esophageal sphincter hypertonia in 47%, lower esophageal sphincter hypotonia in 22% and increase in contraction wave amplitude in 31%. One year after surgery, manometry was altered in 85% of patients: lower esophageal sphincter hypertonia in 11%, lower esophageal sphincter hypotonia in 52%, increase in contraction wave amplitude in 27% and 10% with alteration in esophageal peristalsis. Comparing the results between the preoperative and postoperative periods, was found statistical significance for the variables of the lower esophageal sphincter, amplitude of contraction waves and peristalsis. Conclusion: Manometry in the preoperative period of sleeve gastrectomy is not an exam to select candidates to this technique.

Effects of alterations in bolus viscosity on esophageal peristalsis in humans

1988 ◽  
Vol 254 (1) ◽  
pp. G8-G11 ◽  
Author(s):  
C. P. Dooley ◽  
B. Schlossmacher ◽  
J. E. Valenzuela
Keyword(s):  
Lower Esophageal Sphincter ◽  
Lower Esophageal Sphincter Pressure ◽  
Intraluminal Pressure ◽  
Sphincter Pressure ◽  
Esophageal Peristalsis ◽  
Catheter System ◽  
Bolus Viscosity ◽  
Esophageal Sphincter ◽  
Infused Catheter System ◽  
Initial Change

The effect of increased bolus viscosity on esophageal peristaltic function was studied in six healthy volunteer subjects. Intraluminal pressure events were measured with an infused catheter system and lower esophageal sphincter pressure was monitored continuously with a Dent sleeve. Boluses with viscosities of 2.5, 8.7, 48, and 860 centipoise (cP) were compared with a water bolus. Increasing bolus viscosity to 48 and 860 cP elicited a slowing of wave velocity, an increase in wave duration, and a prolongation of lower esophageal sphincter relaxation. The initial change noted at lower viscosities was an increased duration of contraction wave. Maximal changes were noted at the 48 cP bolus. In conclusion, increased bolus viscosity significantly alters human esophageal peristalsis. These changes may be mediated by esophageal stretch reflexes or by the intrinsic properties of the esophageal musculature or both.

Lidocaine inhibition of esophageal peristalsis and lower esophageal sphincter pressure in baboons

1985 ◽  
Vol 30 (11) ◽  
pp. 1085-1091 ◽  
Author(s):  
Dennis R. Sinar ◽  
Larry C. Carey ◽  
Carmel Cordova ◽  
J. Raymond Fletcher ◽  
Donald O. Castell
Keyword(s):  
Lower Esophageal Sphincter ◽  
Lower Esophageal Sphincter Pressure ◽  
Sphincter Pressure ◽  
Esophageal Peristalsis ◽  
Esophageal Sphincter

Outcome of Pneumatic Balloon Dilatation in Achalasia Cardia

2021 ◽  
Vol 10 (1) ◽  
pp. 8-13
Author(s):  
Shankar Baral ◽  
Bidhan NIdhi Paudel ◽  
Ajit Khanal ◽  
Jiwan Thapa ◽  
Bhuwneshwer Yadhav ◽  
...  
Keyword(s):  
Observational Study ◽  
Lower Esophageal Sphincter ◽  
Poor Response ◽  
Lower Esophageal Sphincter Pressure ◽  
Pneumatic Dilatation ◽  
Response To Treatment ◽  
Sphincter Pressure ◽  
Achalasia Cardia ◽  
Type Iii ◽  
Esophageal Sphincter

Background: Achalasia Cardia is a rare esophageal motility disorder. Among various treatment options, Pneumatic Dilatation (PD) is the most widely used and cost effective modality till date. This is the first observational study aiming to evaluate the short term response and complications of PD for Achalasia Cardia in Nepal. Methods: This prospective observational study was conducted between 28th Jan 2020 to 27th Jan 2021. It included 39 patients with Achalasia Cardia diagnosed by clinical presentation, esophagoscopy, barium esophagogram and high resolution manometry. Two patients of Type III achalasia were excluded from study. Thirty seven patients underwent pneumatic dilatation with 30 mm Rigiflex balloon (Boston Scientific, USA) for a duration of 1 minute. Response was assessed by Eckardts score at 3 and 6 months. Result: Among 39 cases (mean age= 39.03±15.017 years, 59% men), commonest was Type II Achalasia (71.8%) followed by Type I (23.1%) and Type III (5.1%). Dysphagia was present in all patients (100%), followed by weight loss (84.6%), regurgitation (79.5%) and chest pain (35.9%). Mean basal Eckardts score and Lower Esophageal Sphincter pressure of the study population was 7.81±1.24 and 24.40±6.83 respectively. Response to pneumatic dilatation was 89.2%. Eckardts score changed significantly from7.81±1.24 to 1.03±1.82 at 6 months (p<0.001). None of the patients had major complications. Younger age (23±6.377 years) had poor response to treatment, while predilatation Lower Esophageal Sphincter pressure, gender and type of achalasia did not affect the treatment outcome. Conclusion: PD is safe and effective treatment modality for Achalasia. Younger patients have poor response to treatment with Pneumatic Dilatation.  

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