Motility across esophageal anastomoses after esophagectomy or gastrectomy

The esophageal motility of 23 patients who underwent esophagectomy or gastr ectomy for carcinoma of the esophagus or gastroesophageal junction was reco rded daily during the immediate post-operative period for high-pressure tra nsients or other motility disturbances. Patients were divided into three su bgroups according to the level of the esophageal anastomosis: group 1, neck (n = 4); group 2, thoracic (n = 14)I group 3, diaphragmatic hiatus (n = 5) . Peristalsis was absent in all patients studied during ventilation and sed ation in the intensive care unit (five patients). Early post-operative esop hageal motility after esophageal anastomosis varied somewhat with the lengt h of residual esophagus, With short lengths of residual esophagus, no consi stent motility pattern emerged. With longer lengths, early peristaltic acti vity was evident, but diminished ol er the first few post-operative days. E sophageal resection and anastomosis is associated,vith loss of peristalsis in the initial post-operative period, consistent with the concept of an eso phageal ileus.