Thomson D, Shoenut J P, Trenholm B G, Teskey J M
Ann Thorac Surg. 1987 May;43(5):550-3. doi: 10.1016/s0003-4975(10)60208-1.
Five patients with achalasia underwent limited myotomy without fundoplication. Surgery reduced mean lower esophageal sphincter resting pressure significantly (p less than .05) from 31 +/- 9.7 mm Hg to 16.1 +/- 8.2 mm Hg. Twenty-four-hour ambulatory esophageal pH studies demonstrated that the percentage of time the pH in the distal esophagus was below 4 was similar whether the patient was upright or supine (6.6 +/- 6.5% of total time upright vs. 9.1 +/- 12.7% of total time). Reflux events that occur in the supine position may be significant because of their prolonged duration resulting from the absence of normal secondary peristalsis in the body of the esophagus. Patients with achalasia who have undergone esophagomyotomy without fundoplication do not appear to experience more reflux than control subjects with normal esophageal function.
5例贲门失弛缓症患者接受了有限肌切开术，未行胃底折叠术。手术使食管下括约肌平均静息压力从31±9.7mmHg显著降低至16.1±8.2mmHg（p<0.05）。24小时动态食管pH监测显示，无论患者是直立位还是仰卧位，远端食管pH低于4的时间百分比相似（直立位总时间的6.6±6.5% vs. 仰卧位总时间的9.1±12.7%）。仰卧位发生的反流事件可能很显著，因为食管体部缺乏正常的继发性蠕动，导致反流持续时间延长。接受了肌切开术但未行胃底折叠术的贲门失弛缓症患者似乎并不比食管功能正常的对照受试者经历更多的反流。
