Radionuclide transit studies for esophageal function before and after esophageal transection and devascularization.
Nonobstructive swallowing disturbance is a common complication following esophageal transection and devascularization to control bleeding from esophageal varices. From July 1983 to July 1984, 12 patients underwent both a radionuclide esophageal transit study (RETS) and a barium swallowing fluoroscopic study (BSFS) before and after surgery to evaluate esophageal function. Before surgery, 9 of the 12 patients had no swallowing disturbance and the RETS was normal in 8 cases, and the BSFS was normal in all cases. Three patients who received sclerotherapy on more than 3 occasions suffered from swallowing disturbances and both the RETS and BSFS detected their defective passage. The average distal 1/3 segmental and total esophagus transit times were 11.5 +/- 9.9 seconds and 13.0 +/- 10.6 seconds among symptom-free patients; and 24.8 +/- 11.8 seconds and 30.1 +/- 14.6 seconds among swallowing-disturbance patients. The time prolongation was significant (p less than 0.005). After surgery, 5 of 9 preoperative symptom-free patients suffered from swallowing disturbances for 10 days and then became symptom free. Their serial follow-up RETS and BSFS at 1 month, 3 months and 6 months all showed normal results. One preoperative symptom-free patient suffered from a mild swallowing disturbance for 2 months. However, only RETS, but not BSFS, demonstrated the prolonged proximal segmental esophageal transit time at 1 month postoperatively. The remaining 6 patients suffered from prominent swallowing disturbances and their initial postoperative RETS demonstrated prolonged defective transit or the presence of gastroesophageal (GE) reflux. All these events were confirmed by both tests.(ABSTRACT TRUNCATED AT 250 WORDS)
Yu
T J
TJ
Department of Surgery, Veterans General Hospital, Taipei, Taiwan, R.O.C.
Cheng
K K
KK
Yeh
S H
SH
Chiang
J H
JH
D000328:Adult; D000368:Aged; D004932:Esophageal and Gastric Varices / Q000601:surgery*; D004947:Esophagus / Q000098:blood supply / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis; D013667:Technetium
D013667:Technetium