| Project/Area Number |
03670646
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| Research Category |
Grant-in-Aid for General Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Research Field |
Digestive surgery
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| Research Institution | Jikei University School of Medicine |
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Principal Investigator |
HANYU Nobuyoshi Jikei University School of Medicine Second Department of Surgery Lecturer, 医学部, 講師 (30189592)
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| Co-Investigator(Kenkyū-buntansha) |
NAKADA Koji Assistant, Second Department of Surgery, Jikei University School of Medicine, 医学部, 助手 (10227811)
ABE Sadanobu Assistant, Second Department of Surgery, Jikei University School of Medicine, 医学部, 助手 (60231114)
大平 洋一 慈恵医大, 医学部, 助手 (10213852)
FURUKAWA Yoshiyuki Assistant, Second Department of Surgery, Jikei University School of Medicine, 医学部, 助手 (80209171)
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| Project Period (FY) |
1991 – 1992
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| Project Status |
Completed (Fiscal Year 1992)
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| Budget Amount *help |
¥300,000 (Direct Cost: ¥300,000)
Fiscal Year 1992: ¥300,000 (Direct Cost: ¥300,000)
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| Keywords | Reflux esophagitis / Esophageal motor function / Nissen's fundoplication / Lower esophageal sphincter pressure (LESP) / 逆流性食道管 / 下部食道括約筋(LES) / SavaryーMillerの分類 / Nissen噴門形成術 |
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| Research Abstract |
The authors reported in 1991 that the determination of the esophageal manometry revealed the decrease of contractile amplitude, migration velocity in the patients who suffer from reflux esophagitis. As the decreased esophageal motility may induce the decreased esophageal clearance and be a factor of aggravating reflux esophagitis, it seems to have an extremely important meaning. We had previously conducted 360ﾟ NISSEN fundoplication to prevent reflux, but it frequently induced gas bloat syndrome. Then, it is recently replaced with two-thirds fundoplication. From 1991 to 1992, we applied this operation technique to 10 cases of reflux esophagitis to study the post-operative improvement in esophagitis and esophageal motor function. As concrete procedures, the esophageal manometry was determined intraoperatively, fundoplication was conducted and the lower esophageal sphincter pressure (LESP) was adjusted to be 30mmHg. The post-operative LESP was 18.9*7.9mmHg, lower than the intraoperative level and almost at the same level as healthy subjects. The post-operative gas bloat syndrome or other adverse reaction did not occur. Esophagitis was improved and subjective symptoms disappeared in all the cases. The pre-operative contractile amplitude of the esophagus was 30 to 50mmHg (60 to 75mmHg in healthy subjects). The post-operative amplitude was 30 to 40mmHg and the migration velocity was 3 to 5cm/sec (3 to 7cm/sec in healthy subjects), indicating no improvement in esophageal motility soon after the operation. The determination of the esophageal manometry is required in the cases under long-term follow-up and it should be studied whether esophageal motor function can be improved after the operation to prevent reflux.
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