Shono T, Suita S, Arima T, Handa N, Ishii K, Hirose R, Sakaguchi T
Department of Pediatric Surgery, Kyushu University, Fukuoka, Japan.
J Pediatr Surg. 1993 May;28(5):673-6. doi: 10.1016/0022-3468(93)90029-k.
Two patients with a long gap esophageal atresia without tracheoesophageal fistula underwent an esophageal manometric study before primary anastomosis and one of them underwent an identical study after operation. Before operation both patients showed peristaltic contraction in the proximal esophagus when swallowing which was always followed by a coordinated contraction of the distal esophagus the same as in that of the normal esophagus. These peristaltic contractions induced a reflex relaxation of the lower esophageal sphincter (LES). After operation the manometric studies of the repaired esophagus demonstrated an abnormal esophageal motility, with simultaneous contractions occurring when swallowing in the proximal to the distal esophagus. In addition, the reflex relaxation of LES was incomplete. These data suggest that even if the intraluminal continuity is defective, the esophageal motility function is not disturbed in the proximal to distal esophagus in preoperative esophageal atresia, and that intraoperative mobilization and denervation may be suggested to be an important factor in esophageal dysmotility even when esophageal atresia is successfully repaired.
两名患有长节段食管闭锁且无食管气管瘘的患者在初次吻合术前接受了食管测压研究，其中一名患者术后接受了相同的研究。术前，两名患者吞咽时近端食管均出现蠕动收缩，随后远端食管出现与正常食管相同的协调性收缩。这些蠕动收缩引起食管下括约肌（LES）的反射性松弛。术后对修复后的食管进行测压研究显示食管运动异常，吞咽时食管近端至远端同时出现收缩。此外，LES的反射性松弛不完全。这些数据表明，即使管腔内连续性存在缺陷，术前食管闭锁患者食管近端至远端的运动功能并未受到干扰，并且提示术中游离和去神经支配可能是食管闭锁成功修复后食管运动障碍的一个重要因素。
