Manometry data support a novel concept of the lower esophageal sphincter system

Abstract

Based on available data, we propose a novel concept that better explains the structure-function relationship of the LES. Improved knowledge of the biomechanical factors of esophageal disorders can be expected to advance surgical treatment for these diseases.

Ultra-Hochauflösungsmanometrie des oberen Ösophagussphinkters

“…Zum besseren Verständnis des oÖS haben anatomische Präparationen sowie elektromyographische [3,4], kinematographische [5], Impedanz- [6,7] und manometrische Untersuchungen [8,9,10] beigetragen. Aufgrund der anatomischen Varianten und der jeweils verwendeten Untersuchungsmethode wird aber bis heute der anatomische Aufbau des Sphinkters in der Literatur kontrovers diskutiert.…”

“…Aufgrund seines muskulären Aufbaus ist der oÖS ein echter Ringsphinkter und unterscheidet sich damit von der distalen ösophagealen Verschlusszone am Übergang zum Magen, die durch einen Dehnverschluss gebildet wird [6,12,14]. Stelzner et al beschreiben zusätzlich einen Gefäßplexus im oÖS, der im Sinne eines Schwellkörpers den Verschluss vervollständigt (angiomuskulärer Schnürver-schluss) [14,15].…”

Ninety and still active in research

“…As recently as in 2010, he published together with his son his ideas about a novel concept of the lower oesophageal sphincter system [31]. We wish him further good health and are looking forward to see him on our conferences for many more years.…”

Laparoscopic Mesh-augmented Hiatoplasty With Cardiophrenicopexy Versus Laparoscopic Nissen Fundoplication for the Treatment of Gastroesophageal Reflux Disease

“…6,7 This hypothesis has been supported by experimental findings 8 and meticulous considerations on the physiology of the LES by Stelzner et al As a consequence of their research, they postulated a stretch closure mechanism of the LES, which improves after isometric distention of the spiral esophageal muscular fibers. [9][10][11] Initial results of cardiophrenicopexy procedures were promising as reflux control was achieved in up to 90% of patients. 12 However, due to high recurrence rates of up to 60% the technique was abandoned.…”