Department of Surgery, Londrina State University, Rua Santos 777 apto 1302, 86020-041 Londrina, Paraná, Brazil.
Obes Surg. 2012 Jul;22(7):1050-4. doi: 10.1007/s11695-012-0613-4.
Our goal was to identify the changes of esophageal motility, lower esophageal sphincter (LES) function, and eating adaptation before and after Roux-en-Y gastric bypass (RYGBP) and whether manometry should be a routine examination in patients who undergo this procedure.
A total of 81 patients underwent manometry before surgery and 1 year after surgery. The control group consisted of 10 nonobese volunteers. Patients were classified as presenting with vomiting and without vomiting 1 year after surgery. Manometric variables were compared before and after surgery. Statistical analysis was performed using Wilcoxon and Mann-Whitney test.
The patients (45.6%) had preoperative manometric findings, 29.8% had LES hypertonia, 18.9% LES hypotonia, 43.2% increase in wave amplitude of contraction, and three 8.1% abnormal peristalsis. One year after surgery manometry was abnormal in 62.9% of patients, 11.7% with hypertonia and 15.7% with hypotonia of the LES, 53% with changes in amplitude contraction and 19.6% with abnormal peristalsis. The control group showed no manometric abnormalities. Chronic vomiting was noted in 21% of patients. When comparing all variables between the pre and postoperative periods, there was no significant difference for all of them except for peristalsis. Comparing the results of manometric findings between the vomiting and non-vomiting groups, no significant changes were found in the variables studied.
There was an association between RYGBP and motor abnormalities in the esophagus but no differences in postoperative feeding adaptation. Thus, we conclude that esophageal manometry is not necessary as a routine preoperative examination.
我们的目标是确定 Roux-en-Y 胃旁路术（RYGBP）前后食管动力、下食管括约肌（LES）功能和进食适应性的变化，以及在接受该手术的患者中是否应将测压作为常规检查。
共有 81 例患者在术前和术后 1 年进行了测压检查。对照组由 10 名非肥胖志愿者组成。术后 1 年，将患者分为有呕吐症状和无呕吐症状两组。比较手术前后的测压变量。采用 Wilcoxon 和 Mann-Whitney 检验进行统计学分析。
患者术前（45.6%）有测压异常发现，29.8%存在 LES 张力过高，18.9%存在 LES 张力过低，43.2%收缩波幅增加，3 例（8.1%）存在异常蠕动。术后 1 年，62.9%的患者测压异常，11.7%存在 LES 张力过高，15.7%存在 LES 张力过低，53%存在收缩波幅改变，19.6%存在异常蠕动。对照组无测压异常。21%的患者出现慢性呕吐。比较术前和术后所有变量，除蠕动外，其他所有变量均无显著差异。比较有呕吐症状和无呕吐症状组的测压结果，研究变量均无显著变化。
RYGBP 与食管运动异常有关，但术后进食适应性无差异。因此，我们认为食管测压术并非术前常规检查的必要手段。
