title: Dysphagia after antireflux fundoplication: endoscopic, radiological and manometric evaluation.
abstract: BACKGROUND
  The transient dysphagia after fundoplication is common and most often disappears until six weeks postoperatively.
  
  
  OBJECTIVE
  Analyze a group of patients who presented late and persistent dysphagia postoperatively.
  
  
  METHODS
  Forty-one patients after Nissen fundoplication, 14 male and 27 female, mean age 48 year, were evaluated based on medical history, esophagogastroduodenoscopy, contrast radiographic examination and esophageal manometry. The results were compared with another 19 asymptomatic individuals.
  
  
  RESULTS
  Contrast radiographic examination of the esophagus revealed in six cases delayed emptying, characterizing that four patients had achalasia and two diffuse spasm of the esophagus. Esophageal manometry showed that maximal expiratory pressure of the lower sphincter ranged from 10 to 38 mmHg and mean respiratory pressure from 14 to 47 mmHg, values similar to controls. Residual pressure ranged from 5 to 31 mmHg, and 17 patients had the same values as the control group.
  
  
  CONCLUSIONS
  The residual pressure of the lower sphincter was higher and statistically significant in patients with dysphagia compared with those operated without dysphagia. Future studies individualizing and categorizing each motility disorder, employing other techniques of manometry, and the analysis of the residual pressure may contribute to understand of persistent dysphagia in the postoperative fundoplication.
authors: Departamento de Cirurgia, Faculdade de Ciências Médicas, Unicamp, Campinas, SP, Brazil.
authors: Drausio Jeferson
authors: DJ
authors: Morais
authors: Departamento de Cirurgia, Faculdade de Ciências Médicas, Unicamp, Campinas, SP, Brazil.
authors: Luiz Roberto
authors: LR
authors: Lopes
authors: Departamento de Cirurgia, Faculdade de Ciências Médicas, Unicamp, Campinas, SP, Brazil.
authors: Nelson Adami
authors: NA
authors: Andreollo
mesh_terms: D000328:Adult; D000368:Aged; D003680:Deglutition Disorders / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D004945:Esophagoscopy; D005260:Female; D018662:Fundoplication / Q000009:adverse effects*; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011859:Radiography
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