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Wäsche A, Kandulski A, Malfertheiner P, et al. Impact of thoracic surgery on esophageal motor function-Evaluation by high resolution manometry. J Thorac Dis. 2017;9(6):1557-1564doi: 10.21037/jtd.2017.05.43.
Wäsche, A., Kandulski, A., Malfertheiner, P., Riedel, S., Zardo, P., Hachenberg, T., & Schreiber, J. (2017). Impact of thoracic surgery on esophageal motor function-Evaluation by high resolution manometry. Journal of thoracic disease, 9(6), 1557-1564. https://doi.org/10.21037/jtd.2017.05.43
Wäsche, Anja, et al. "Impact of thoracic surgery on esophageal motor function-Evaluation by high resolution manometry." Journal of thoracic disease vol. 9,6 (2017): 1557-1564. doi: https://doi.org/10.21037/jtd.2017.05.43
Wäsche A, Kandulski A, Malfertheiner P, Riedel S, Zardo P, Hachenberg T, Schreiber J. Impact of thoracic surgery on esophageal motor function-Evaluation by high resolution manometry. J Thorac Dis. 2017 Jun;9(6):1557-1564. doi: 10.21037/jtd.2017.05.43. PMID: 28740669; PMCID: PMC5506166.
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J Thorac Dis. 2017 Jun;9(6):1557-1564. doi: 10.21037/jtd.2017.05.43.

Impact of thoracic surgery on esophageal motor function-Evaluation by high resolution manometry.

Journal of thoracic disease

Anja Wäsche, Arne Kandulski, Peter Malfertheiner, Sandra Riedel, Patrick Zardo, Thomas Hachenberg, Jens Schreiber

Affiliations

  1. Department of Pneumology, University Hospital Magdeburg, Magdeburg, Germany.
  2. Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Magdeburg, Magdeburg, Germany.
  3. Division of Cardiothoracic Surgery, University Hospital Magdeburg, Magdeburg, Germany.
  4. Department of Anaesthesiology and Intensive Care Medicine, University Hospital Magdeburg, Magdeburg, Germany.

PMID: 28740669 PMCID: PMC5506166 DOI: 10.21037/jtd.2017.05.43

Abstract

BACKGROUND: Alteration of esophageal function is a potential risk factor for postoperative complications in thoracic surgery. This prospective study investigates esophageal motility and function during and after thoracic procedures via high resolution manometry (HRM) and impedance technology with spatiotemporal representation of pressure data.

METHODS: Twelve consecutive patients eligible for elective thoracic surgery underwent preoperative and postoperative (48 hours and 7 days) esophageal HRM. Swallowing acts were carried out with 5 mL of water, 10 mL of water and 1 cm

RESULTS: All patients were investigated 48 hours prior to and 7 days after thoracic procedures, with a total of n=675 swallowing acts being included in our study. Increased motility patterns of the tubular esophagus occurred temporally 48 hours postoperatively. DCI 48 hours after surgery increased significantly (5 mL, P=0.049; solid, P=0.014) and returned to baseline values after seven days (5 mL, P=0.039; solid, P=0.039). Break length was significantly reduced 48 hours postoperatively, especially in the proximal esophageal segment (transition zone). Follow-up measurements after another week were comparable to preoperative baseline findings. The perioperative MII-pH measurement showed numerous artifacts caused by intubation and ventilation during surgery also with increasing short and frequent acidic reflux episodes.

CONCLUSIONS: Thoracic procedures cause a transient modulation of esophageal peristalsis with postoperative increased contractility of the tubular esophagus, presumably without affecting intraesophageal reflex arcs. Although limited by the number of patients, we can conclude on our data that postoperative esophageal hypomotility is unlikely to promote secondary pulmonary complications.

Keywords: Chicago Classification; Esophageal motility; high resolution manometry; thoracic surgery; thoracoscopy; thoracotomy

Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

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