BackgroundThe transient dysphagia after fundoplication is common and most often disappears
until six weeks postoperatively.AimAnalyze a group of patients who presented late and persistent dysphagia
postoperatively.MethodsForty-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.ResultsContrast 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.ConclusionThe 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.
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