Probrems and Remedies after Esophageal Reconstruction

Minoru Muraoka, Teruo Kouzu, Akio Sakamoto, Yoshio Koide, Shinnichi Miyazaki, Kaichi Isono

Second Department of Surgery, Chiba University School of Medicine

The relationship between swallowing function and mis-swallowing after an operation for esophageal reconstruction was studied by measuring the esophageal inner pressure. Fifty-three outpatients with resected esophageal cancer in our department were studied. Esophageal inner pressure on swallowing was measured by the stationary pull-through method using a transducer with 4-channel microchips and pressure at rest of the cervical esophagus was measured by the rapid pull-through method. The ratio of the preceding negative wave to the following positive wave in swallowing pressure was 10.20 ± 1.30 (M ± SE) in the mis-swallowing group and 3.59 ± 0.29 in the group without mis-swallowing, with a statistically significant difference. The ratio of inner pressure at rest around the upper esophageal sphincter and around the anastomosis in the cervical esophagus was 1.73 ± 0.34 in the mis-swallowing group and 0.79 ± 0.17 in the group without mis-swallowing. This difference was also statistically significant. The distance between the upper esophageal sphincter and the anastomosis was 2.2 ± 0.3 cm in the mis-swallowing group and 3.7 ± 0.6 cm in the group without mis-swallowing, with statistically significant differece.

Key words
esophageal reconstruction, innerpressure of cervical esophagus, aspiration pneumonia

Reprint requests
Minoru Muraoka Second Department of Surgery, Chiba University School of Medicine
1-8-1 Inohana, Chuo-ku, Chiba, 260 JAPAN

Accepted
June 14, 1995

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