Cooper J D, Gill S S, Nelems J M, Pearson F G
J Thorac Cardiovasc Surg. 1977 Nov;74(5):744-51.
The combination of a Collis gastroplasty with a Belsey Mark IV fundoplication has proved clinically effective in the management of certain patients with complications of gastroesophageal reflux. The present study measured the effect of gastroplasty and Belsey repair on intraluminal pressure changes in the gastroplasty and lower esophagus. Manometric studies were performed preoperatively, intraoperatively, and postoperatively. In each case the gastroplasty segment of the esophagus was found to function as a high pressure zone (HPZ). The pressure in this zone further increased following the fundoplication. It could be diminished with intravenous administration of Buscopan and augmented with intravenously given pentagastrin. The original lower esophageal sphincter in most instances was included in the upper segment of the gastroplasty tube, but the entire length of the gastroplasty tube functioned as an HPZ, and pressures in the tube were considerably higher than those originally present in the lower esophageal sphincter. These studies provide a physiological rationale for the effectiveness of gastroplasty and fundoplication.
考利斯胃成形术与贝尔西Mark IV胃底折叠术联合应用已被证明在治疗某些胃食管反流并发症患者方面具有临床疗效。本研究测量了胃成形术和贝尔西修复术对胃成形术段及食管下段腔内压力变化的影响。在术前、术中和术后进行了测压研究。在每种情况下，食管的胃成形术段均被发现起到高压区（HPZ）的作用。胃底折叠术后该区域的压力进一步升高。静脉注射解痉灵可使其降低，静脉注射五肽胃泌素则可使其升高。大多数情况下，原来的食管下括约肌包含在胃成形术管的上段，但胃成形术管的整个长度都起到高压区的作用，且管内压力明显高于原来食管下括约肌的压力。这些研究为胃成形术和胃底折叠术的有效性提供了生理学依据。
