Characterization of esophageal motility following esophageal atresia repair using high-resolution esophageal manometry.
BACKGROUND
Esophageal dysmotility, a considerable issue following esophageal atresia (EA) repair, has been reported but has not been precisely described and characterized. Using high-resolution esophageal manometry (HREM), we characterized the esophageal motility patterns in children with repaired EA and compared these patterns of dysmotility with symptomatology.


METHODS
HREM was performed as an outpatient procedure in patients with repaired EA. The tracings were analyzed using the software provided by the company and were then reviewed visually. Charts were reviewed for medical/surgical histories and symptoms were assessed by a standardized questionnaire.


RESULTS
Forty patients (25 boys, 15 girls) with a median age of 8 years (11 months-18 years) underwent an HREM. Thirty-five patients had type C EA and 5 had type A EA. Only 7 patients were asymptomatic at the time of the examination. HREM results were abnormal in all of the patients. Three different esophageal motility patterns were derived from HREM tracing analysis: aperistalsis (15 patients, 38%), pressurization (6 patients, 15%), and distal contractions (19 patients, 47%). Distal contractions pattern was found exclusively in type C EA. Dysphagia was encountered in the 3 groups. Gastroesophageal reflux disease-related symptoms predominated in the aperistalsis group.


CONCLUSIONS
HREM improves our understanding and allows precise characterization of esophageal dysmotility in patients who have undergone EA repair.
Division of Pediatric Surgery, Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montréal, Québec, Canada.
Caroline
C
Lemoine
Ann
A
Aspirot
Gaelle
G
Le Henaff
Hugues
H
Piloquet
Dominique
D
Lévesque
Christophe
C
Faure
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003680:Deglutition Disorders / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D004933:Esophageal Atresia / Q000601:surgery*; D015154:Esophageal Motility Disorders / Q000209:etiology / Q000503:physiopathology* / Q000517:prevention & control; D004947:Esophagus / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D005764:Gastroesophageal Reflux / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D006776:Hospitals, Pediatric; D006784:Hospitals, Teaching; D006801:Humans; D007223:Infant; D008297:Male; D008365:Manometry; D010044:Outpatient Clinics, Hospital; D010528:Peristalsis; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology* / Q000517:prevention & control; D012189:Retrospective Studies; D012720:Severity of Illness Index