title: Internal pressure of the conduit during endoscopy on the day after esophagectomy.
abstract: BACKGROUND
  In gastrointestinal surgery, anastomosis can result in various complications. Anastomosis is evaluated using classical examinations. The most reliable one is endoscopy, which provides direct information on the anastomosis and conduit. But the influence of endoscopy on anastomosis is uncertain.
  
  
  METHODS
  The internal pressure of a graft during endoscopy was measured in 36 patients who received esophagectomy, by utilizing the decompression tube which was inserted into the graft during operation. We filled the tube with water and measured the maximum water level in a centimeter water column. All examinations were routinely performed on the day after operation, and thin endoscopes were selected for reducing the stress.
  
  
  RESULTS
  The internal pressure before endoscopy ranged from 6 to 20 cm H2O, and during endoscopy ranged from 9 to 27 cm H2O. The difference in the internal conduit pressure in each patient ranged from 1 to 9 cm H2O. There was no increase in complications caused by endoscopy, including anastomotic leakage.
  
  
  CONCLUSIONS
  This study is the first to report changes in internal pressure due to the endoscope by direct measurement. The pressure gradient observed was below the physiological pressure during swallowing. These results suggest that endoscopy is a safe examination even after surgery.
authors.affiliation: Department of Esophageal and Gastric Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Okada
authors.forename: Kenro
authors.initials: K
authors.lastname: Kawada
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Nakajima
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Tokairin
authors.forename: Kagami
authors.initials: K
authors.lastname: Nagai
authors.forename: Tatsuyuki
authors.initials: T
authors.lastname: Kawano
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D057868:Anastomotic Leak / Q000209:etiology; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects / Q000295:instrumentation; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy; D004947:Esophagus / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011312:Pressure / Q000009:adverse effects; D013270:Stomach / Q000601:surgery*