title: Preoperative predictability of the short esophagus: endoscopic criteria.
abstract: BACKGROUND
  Short esophagus is a common cause of failure of antireflux surgery. Minimally invasive intervention for short esophagus is technically difficult. Reliable predictors of short esophagus would allow appropriate referral and better outcomes. The aim of this study is to investigate the preoperative predictability of the short esophagus in patients undergoing antireflux surgery.
  
  
  METHODS
  Eighty-five patients with Collis gastroplasty and antireflux surgery (1994-2007) at a single institution form group A. Control group (B) comprises 205 consecutive patients undergoing primary antireflux surgery (2004-2007). Retrospective review of prospectively collected data was completed. Esophageal length index (ELI) was calculated as the ratio of endoscopic esophageal length (in cm) to height (in meters).
  
  
  RESULTS
  Patients requiring Collis gastroplasty (group A) tend to be older while there were no significant differences in sex, height, weight, and body mass index distribution between groups. Mean endoscopic esophageal length (EEL) as measured from incisor to esophagogastric junction was significantly shorter in group A (32.4 cm) as compared with group B (36.2c m) (p < 0.0001). Esophageal length index (ELI) of less than 19.5 had 83% negative predictive value with 95% specificity.
  
  
  CONCLUSIONS
  Patients with an ELI of less than 19.5 or with stricture have higher risk for having a short esophagus.
authors.affiliation: Department of Surgery, Creighton University Medical Center, 601 North 30th Street, Suite 3700, Omaha, NE 68131-2197, USA.
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Yano
authors.forename: Rudolf J
authors.initials: RJ
authors.lastname: Stadlhuber
authors.forename: Kazuto
authors.initials: K
authors.lastname: Tsuboi
authors.forename: Nitin
authors.initials: N
authors.lastname: Garg
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Filipi
authors.forename: Sumeet K
authors.initials: SK
authors.lastname: Mittal
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D004947:Esophagus / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005764:Gastroesophageal Reflux / Q000601:surgery*; D015391:Gastroplasty / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011300:Preoperative Care / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D055815:Young Adult