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Is the measurement of LES always parallel to the functional results of an antireflux procedure?

  • T. R. DeMeester
  • P. Denis
  • J. Y. Touchais
  • F. Michot
  • P. Ténière
Conference paper

Abstract

Increased esophageal exposure to gastric juice can be caused by esophageal, sphincter or gastric abnormahties. An antireflux procedure is a mechanical therapeutic approach to the problem of increased esophageal acid exposure by improving the competency of the sphincter. It will reduce esophageal exposure to gastric juice regardless of the cause but is less likely to produce troublesome side effects when used to correct a manometrically defective sphincter. The grounds for this statement are as follows:
  1. 1.

    Mechanical failure of the sphincter is recognized by inadequate manometric findings. Fig. 1 illustrates the important measurements. They are:

     
  2. a)

    an average sphincter pressure of 6mm Hg or less;

     
  3. b)

    an average length of sphincter exposed to the positive pressure environment of the abdomen of less than 1cm; and/or

     
  4. c)

    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.

     

Keywords

Lower Esophageal Sphincter Esophageal Acid Exposure Antireflux Procedure Gastroenterol Clin Biol Esophageal Exposure 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

References

  1. 1.
    Zaninotto G, DeMeester TR, Schwizer W etal The Lower Esophageal Sphincter in Health and Disease. Am J Surg (In Press)Google Scholar
  2. 2.
    DeMeester TR, Bonavina L, Albertucci M (1986) Nissen fundophcation for gastroesophageal reflux disease: evaluation of primary repair in 100 consecutive patients. Ann Surg 204(1): 9–20PubMedCrossRefGoogle Scholar

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Copyright information

© Springer-Verlag Berlin Heidelberg 1989

Authors and Affiliations

  • T. R. DeMeester
    • 1
  • P. Denis
    • 2
  • J. Y. Touchais
    • 2
  • F. Michot
    • 2
  • P. Ténière
    • 2
  1. 1.OmahaUSA
  2. 2.RouenFrance

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