Gastric motility disorders in patients operated on for esophageal atresia and tracheoesophageal fistula: Long-term evaluation

Background/Purpose: Disturbed peristalsis is reported frequently after succ essful repair of esophageal atresia (EA). Delayed gastric emptying could be considered a cause of symptoms of gastroesophageal reflux (GER) in patient s with repaired EA. The aim of the current study was to evaluate the incide nce of and to characterize gastric motility disorders in a long-term follow -up of patients operated on for EA-tracheoesophageal fistula (TEF) by study ing gastric emptying with scintigraphic techniques and comparing the result s with gastric manometric data. Methods: Eleven patients, between 12 and 23 years of age (median, 17) opera ted on for EA-TEF between 1975 and 1985, were studied. The scinthigraphic s tudy was undertaken using a standard solid meal. The manometric study was p erformed using a 2.3-mm probe with 3 solid-state transducers. Results: Dysphagia was present in about 20% of patients. Dyspepsia was reco rded in 40% of the patients. A pathological reflux was present in 2 patient s. Delayed gastric emptying (T1/2 > 90') was present in 4 patients (36%). M anometric data showed alteration of gastric peristaltic activity in 5 patie nts (45%). Conclusions: Delayed gastric emptying is frequent in longterm follow-up of patients operated on for EA-TEF. In these patients antral hypomotility also is recorded manometrically. Abnormal gastric motility can be considered as an important factor predisposing to symptoms of GER. A thorough evaluation of gastric function is recommended in symptomatic patients after EA repair . Copyright (C) 2000 by W.B. Saunders Company.