By Cedric G. Bremner, Tom R. DeMeester
This paintings makes a speciality of the physiologic method of the certainty and administration of oesophageal sickness. this can be coupled with the usage of minimally invasive thoracoscopic and laparoscopic surgical procedure as a primary choice within the remedy of gastroesophageal reflux disorder. oesophageal motility problems, oesophageal diverticula, and benign oesophageal tumours. Open surgical procedure is reserved for the preliminary method of complex oesophageal illness, reopeation of formerly failed systems, or oesophageal alternative for end-stage benign ailment. This quantity goals to give the present prestige of a altering method of the sphere of oesophageal surgery.
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Extra resources for Modern Approach to Benign Esophageal Disease: Diagnosis and Surgical Therapy
This is possible with the use of ambulatory esophageal pH monitoring, first described by Miller55 in 1964. 14 The test is performed using a small pH electrode passed transnasally and placed 5 cm above the upper border of the LES as measured by manometry. Different probes are available, but bipolar glass electrodes are preferred because of their greater reliability57 and the elimination of an external reference electrode. The electrode is connected to an external portable solid-state data logger and pH values of the distal esophagus are continuously recorded, at 4-second intervals, for 24 hours, a complete circadian cycle.
The transducers are calibrated at 0 and 50 mm Hg by immersion in a water column before and after the test. Eventual drifts must not exceed 8 mm Hg to make the test reliable. ), and data are stored at an 8 Hz sampling rate. After placement of the catheter, the patients are sent home and encouraged to perform Preoperative Assessment of Esophageal Function mmHg dinner sleep 39 breakfast 80 Pharyngeal transducer Esophageal transducers 5 cm above LES Gastric pH 14:00 18:00 22:00 2:00 6:00 10:00 Fig.
In Pearson FG, ed. Esophageal Surgery. ) Preoperative Assessment of Esophageal Function 33 when (1) a motility disorder of the esophageal body and/or the LES is suspected from symptoms of dysphagia, regurgitation, or chest pain; (2) a comprehensive evaluation of the antireflux mechanism in GERD is desired; or (3) a disturbance of the pharyngoesophageal phase of swallowing is suspected. Functional Disorders of the Esophageal Body and LES Abnormalities occurring in the worm-drive pump of the esophageal body or the LES give rise to a number of disorders in the esophageal phase of swallowing.