Manometric evaluation of postoperative patients of esophageal atresia and tracheo-esophageal fistula.
Symptoms related to esophageal dysmotility are common following successful repair of esophageal atresia (EA) and tracheo-esophageal fistula (TEF). Esophageal manometry was performed in 27 survivors of EA/TEF at a mean age of 30.5 +/- 30.3 months and in 25 age-matched controls (mean age 36.8 +/- 22.6 months). The patients were also evaluated clinically to grade them into 3 result-oriented groups "Excellent", "Good" and "Fair", depending on pre-existing criteria evaluating the ability and ease of swallowing. Gastroesophageal reflux (GER) was evaluated with the help of a radionuclide scan. The mean esophageal and peak esophageal pressures and therefore also the lower esophageal sphincter (LES) pressure were lower in the patients (12.4 +/- 5.5, 34.9 +/- 20.4 and 12.2 +/- 6.8 mm Hg, respectively) compared to the controls (21.1 +/- 6.9, 62.3 +/- 19.3 and 16.8 +/- 4.3 mm Hg, respectively). The mean body pressures were highest with "Excellent" results and lowest with "Fair" results and the LES pressures followed a similar trend. Likewise, in the patients with GER, LES pressure was 12.0 +/- 7.1, 12.3 +/- 3.7, 11.0 +/- 5.7 and 6.9 +/- 5.6 mm Hg with nil, mild, moderate and severe GER, respectively. The pressure and contractility profile of the esophagus was abnormal in the majority of patients, even in the absence of symptoms.
Dutta
H K
HK
Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India.
Grover
V P
VP
Dwivedi
S N
SN
Bhatnagar
V
V
D016022:Case-Control Studies; D002675:Child, Preschool; D004933:Esophageal Atresia / Q000150:complications / Q000601:surgery*; D015154:Esophageal Motility Disorders / Q000209:etiology / Q000503:physiopathology; D005764:Gastroesophageal Reflux / Q000209:etiology*; D006801:Humans; D007223:Infant; D008365:Manometry / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology* / Q000503:physiopathology; D014138:Tracheoesophageal Fistula / Q000150:complications / Q000601:surgery*