Parrilla P, Martinez de Haro L F, Ortiz A, Morales G, Garay V, Aguilar J
Department of Surgery, University Hospital, V. Arrixaca, El Palmar, Murcia, Spain.
Am J Gastroenterol. 1995 May;90(5):713-7.
To assess the reappearance of peristalsis in a group of 45 patients with achalasia of the cardia undergoing surgery and to analyze the factors involved in this phenomenon.
According to the postoperative manometric data, the 45 patients were divided into two groups, depending on whether or not they presented a return of peristalsis. A statistical comparison of age, sex, duration of the disease, pre- and postoperative radiological diameter of the esophagus, classic or vigorous nature of the achalasia, and manometric data of the lower esophageal sphincter and esophageal body was made.
In 46.6% of the patients, peristalsis returned to the upper esophagus, and 100% of the waves were progressive; in 24.4%, peristalsis returned to the middle third also, but only 50% of the waves were progressive; and in 8.8% (four patients), peristalic activity returned to the whole esophagus, but only 40% of the waves were progressive. The group of patients with a return of peristalsis had a shorter duration of dysphagia, less preoperative dilation of the esophagus, and a greater contractile activity of the esophageal body.
Return of peristalsis is a frequent phenomenon after myotomy in patients with achalasia of the cardia, especially in cases of short clinical evolution, little esophageal dilation, and a conserved contractile capacity, although its accurate production mechanism is unknown.
评估45例贲门失弛缓症患者接受手术后蠕动的再现情况，并分析与此现象相关的因素。
根据术后测压数据，将45例患者分为两组，取决于他们是否出现蠕动恢复。对年龄、性别、病程、术前和术后食管放射学直径、失弛缓症的经典或强力性质以及食管下括约肌和食管体的测压数据进行统计学比较。
46.6%的患者蠕动恢复至食管上段，其中100%的波是进行性的；24.4%的患者蠕动也恢复至食管中下段，但只有50%的波是进行性的；8.8%（4例患者）的患者蠕动活动恢复至整个食管，但只有40%的波是进行性的。蠕动恢复的患者组吞咽困难病程较短，术前食管扩张较轻，食管体收缩活动较强。
贲门失弛缓症患者行肌切开术后蠕动恢复是一种常见现象，尤其是在临床病程短、食管扩张小且收缩能力保留的情况下，尽管其确切产生机制尚不清楚。
