Schopf B W, Blair G, Dong S, Troger K
Department of Surgery, University of British Columbia, Vancouver, Canada.
J Invest Surg. 1997 May-Jun;10(3):105-14. doi: 10.3109/08941939709032140.
The exact mechanism by which the lower esophageal sphincter (LES) prevents gastroesophageal reflux disease (GERD) remains controversial. The two main reasons for this controversy are the lack of a good animal model and the only recent technologic advances in this field. To date, no animal models exist that use 24-hour pH studies, manometry, and endoscopy in evaluating GERD. The purpose of this study is to create a good model of GERD that uses this technology and to delineate the true nature of the LES more clearly. Recently, three-dimensional vector volume studies were performed and through detailed, cadaveric, anatomic studies, the vector volume profiles were correlated to distinct groups of muscle fibers at the gastroesophageal junction in humans. In this study, an anatomic analysis of the porcine gastroesophageal junction revealed an arrangement of muscle fibers similar to that in humans. A myectomy of the porcine oblique fibers was performed in nine piglets weighing 10 to 12 kg. The authors were able to demonstrate manometric attenuation of the porcine LES, gastroesophageal reflux by ambulatory 24-hour pH monitoring (P < 0.0025), and the creation of GERD by documenting esophagitis grossly and histologically. In conclusion, this model of GERD works and lends further support to the notion that the LES may be a discrete anatomic entity.
食管下括约肌（LES）预防胃食管反流病（GERD）的确切机制仍存在争议。造成这种争议的两个主要原因是缺乏良好的动物模型以及该领域最近才取得技术进步。迄今为止，尚无在评估GERD时使用24小时pH监测、测压法和内窥镜检查的动物模型。本研究的目的是创建一个使用该技术的良好GERD模型，并更清楚地描绘LES的真实性质。最近进行了三维向量体积研究，并通过详细的尸体解剖学研究，将向量体积轮廓与人类胃食管交界处不同组的肌纤维相关联。在本研究中，对猪胃食管交界处的解剖分析显示其肌纤维排列与人类相似。对9只体重10至12千克的仔猪进行了猪斜肌纤维切除术。作者能够证明猪LES的测压减弱、通过动态24小时pH监测发现胃食管反流（P < 0.0025），并通过大体和组织学记录食管炎来证实GERD的形成。总之，这种GERD模型有效，并进一步支持了LES可能是一个离散解剖实体的观点。
