The Journal of Thoracic and Cardiovascular Surgery, Vol 70, 126-132, Copyright © 1975 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Pre- and postoperative manometric studies in diffuse esophageal spasm
F Paris, A Benages, J Berenguer, E Blasco, G Garrido, P Parrilla, MT Ridocci and C Carbonell
Since January, 1972, the authors have operated upon 4 patients with
idiopathic diffuse exophageal spasm. Clinical details and barium studies
are included. Extramucosal myotomy extending from the gastric fundus to the
aortic arch was done in each case. Pre- and postoperative manometric
studies were carried out in all. After operation in each patient the
dysphagia and substernal pain disappeared and in 3 patients radiological
patterns changed. The myotomy was associated with marked fall of
contractile wave pressures in the body of esophagus. The basal pressures of
the esophageal body elevated, in 2 cases fell after the myotomy; in 2 with
normal preoperative pressure it remained unchanged. At the lower esophageal
sphincter the resting and yield pressures remained similar to the
preoperative readings but the myotomy produced a disappearance of the
relaxation and contraction pressure. The authors conclude that with myotomy
they cannot correct the nature of the functional disorder but, by reducing
the amplitude of the waves and lowering the resting pressure if elevated,
they can relieve the patient's symptoms.
