Gastric motility disorders in patients operated on for esophageal atresia and tracheoesophageal fistula: long-term evaluation.
OBJECTIVE
Disturbed peristalsis is reported frequently after successful repair of esophageal atresia (EA). Delayed gastric emptying could be considered a cause of symptoms of gastroesophageal reflux (GER) in patients with repaired EA. The aim of the current study was to evaluate the incidence of and to characterize gastric motility disorders in a long-term follow-up of patients operated on for EA-tracheoesophageal fistula (TEF) by studying gastric emptying with scintigraphic techniques and comparing the results with gastric manometric data.


METHODS
Eleven patients, between 12 and 23 years of age (median, 17) operated on for EA-TEF between 1975 and 1985, were studied. The scinthigraphic study was undertaken using a standard solid meal. The manometric study was performed using a 2.3-mm probe with 3 solid-state transducers.


RESULTS
Dysphagia was present in about 20% of patients. Dyspepsia was recorded in 40% of the patients. A pathological reflux was present in 2 patients. Delayed gastric emptying (T1/2 > 90') was present in 4 patients (36%). Manometric data showed alteration of gastric peristaltic activity in 5 patients (45%).


CONCLUSIONS
Delayed gastric emptying is frequent in long-term follow-up of patients operated on for EA-TEF. In these patients antral hypomotility also is recorded manometrically. Abnormal gastric motility can be considered as an important factor predisposing to symptoms of GER. A thorough evaluation of gastric function is recommended in symptomatic patients after EA repair.
Romeo
C
C
Institute of Pediatric Surgery, Policlinico Viale Gazzi, Messina, Italy.
Bonanno
N
N
Baldari
S
S
Centorrino
A
A
Scalfari
G
G
Antonuccio
P
P
Centonze
A
A
Gentile
C
C
D000293:Adolescent; D000328:Adult; D002648:Child; D013505:Digestive System Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D004933:Esophageal Atresia / Q000150:complications / Q000601:surgery*; D015154:Esophageal Motility Disorders / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D005746:Gastric Emptying / Q000502:physiology; D006801:Humans; D015994:Incidence; D008297:Male; D008365:Manometry; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D014138:Tracheoesophageal Fistula / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome