[Rationale of the surgical treatment of duodenogastroesophageal reflux].

Patients with "intact stomach" but more frequently patients operated on the esophago-gastric junction, vagus, stomach, can develope a duodeno-gastro-esophageal reflux syndrome. We propose a rationale of the surgical treatment based upon our experiences during these last 15 years in functional studies, mainly manometric, of the entire esophago-gastro-duodeno-jejunal tract. Patients with an intect stomach: a non-demolitive ("functional") technique may be proposed each time a correctable alteration of the gastro-duodenal motility is found during the manometric study.

[Esophago-gastro-intestinal manometry: study methods and potential clinical applications].

Simultaneous manometry of the esophagus and stomach and/or of the jejunum is an unconventional investigative maneuver that, for the most part, maintains features typical of a physiopathologic inquiry rather than those of clinical testing. This method contemplates the radiologically guided installation of an 8-channel probe, with measuring sites spaced 5 cm one from the other. The proximal measuring site is generally positioned at the lower esophageal sphincter (LES), while the remaining are chosen in order to attain 3 or 4 tips in the stomach and 2 or 3 tips in the duodenum (in the jejunum following stomach resection).

[Functional evaluation of gastric and jejunal transplant after esophagectomy].

Increased survival rates after esophagectomy for cancer and the significant development of forms of therapy alternate to surgical treatment, today compel surgeons to devote far more attention to the methods will pursue in reconstructing the alimentary tract after removal of the esophagus. Nine patients with esophago-gastro-plasty and 6 with esophago-jejuno-plasty, after esophagectomy for cancer, experienced a study of esophageal function. The study consisted of extended esophago-gastro-intestinal manometry, performed both while at digestive rest after a semi-solid meal, and of scintigraphy, performed to investigate gastric emptying.