Is the measurement of LES always parallel to the functional results of an antireflux procedure?
Mechanical failure of the sphincter is recognized by inadequate manometric findings. Fig. 1 illustrates the important measurements. They are:
an average sphincter pressure of 6mm Hg or less;
an average length of sphincter exposed to the positive pressure environment of the abdomen of less than 1cm; and/or
a sphincter with an average overall length of less than 2 cm. The key factor in the competency of the cardia is at the distal esophageal sphincter pressure, but the efficiency of the pressure can be nullified by inadequate abdominal length or an abnormally short overall sphincter length.
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- 1.Zaninotto G, DeMeester TR, Schwizer W etal The Lower Esophageal Sphincter in Health and Disease. Am J Surg (In Press)Google Scholar
- 1.DeMeester TR, Bonavina L, Albertucci M (1986) Nissen fundophcation for gastroesophageal reflux disease. Evaluation of primary repair in 100 consecutive patients. Am Surg 204:9–20Google Scholar