Histologic and Manometric Studies on the Esophagus Following Endoscopic Sclerotherapy |
| |
Authors: | Peeyush Sharma Inga Hagerstrand Dave Krishan Sharma |
| |
Institution: | (1) Department of Surgery, Lund University Hospital, Lund, Sweden;(2) Department of Pathology, Lund University Hospital, Lund, Sweden;(3) Present address: Department of Surgery, West Cumberland Hospital, Helsingham, Whitehaven, UK;(4) P.O. Box 897, Peterborough, PE1 9DJ, UK |
| |
Abstract: | Objective The aim of this work was to study the histologic and manometric changes in the distal esophagus beyond 2 years following
endoscopic sclerotherapy (EST) and/or surgical intervention, and to try to understand the etiological factors associated with
these changes. Patients and interventions Forty patients, with an average age of 61.5 years, were studied for 2–12 years following sclerotherapy and/or surgical intervention.
The causes of liver disease were alcoholic cirrhosis (78.6%), primary biliary cirrhosis (14.3%), and chronic aggressive hepatitis
(7.1%). A predominant number of cases (65%) had a mesocaval interposition shunt due to the failure of EST, 32.5% EST alone,
and 2.5% esophageal devascularization. All patients had esophageal manometry following mucosal biopsies taken in duplicate
endoscopically from three levels of the distal esophagus. Results In the EST and shunt groups, 88.5% had manometric abnormalities, esophagitis, and chronic inflammatory changes. In the EST
group, all but two patients had manometric abnormalities and chronic inflammatory changes. Analysis of the patient groups
on the basis of the number of EST sessions and the amount of sclerosant injected showed that both histologic changes and dysmotility
were more profound in those treated over five times with EST. The differences were significant. Conclusion It appears that EST causes persistent manometric abnormalities and chronic inflammatory changes in the distal esophagus,
the severity of which seems to vary directly with the frequency of sclerotherapy and not amount of sclerosant injected. |
| |
Keywords: | Endoscopic sclerotherapy (EST) Esophagus Manometry Lower esophageal sphincter (LES) Peristalsis Histology |
本文献已被 SpringerLink 等数据库收录! |
|