Preoperative oesophageal motor activity does not predict postoperative dysphagia

Abstract

Objective: To evaluate the ability of preoperative manometric examinations to predict temporary or permanent dysphagia after antireflux procedures. Design: Retrospective study. Setting: Teaching hospital, Sweden. Subjects: 191 patients who had partial fundoplication. Interventions: Stationary manometry with a perfused catheter system. Main outcome measures: Correlation between preoperative manometric examinations and the incidence of dysphagia before and after operation. Results: 98 of 191 patients had dysphagia preoperatively (51%), but 52 of the 98 had no stricture or motor disorder to explain it; 25 of 59 patients with motor disorders shown manometrically (42%) did not complain of dysphagia. The number of patients with dysphagia was reduced to 43 postoperatively. 8 who did not complain of dysphagia preoperatively did so postoperatively; 4 of 8 had defective peristalsis and 4 had normal preoperative tracings. Conclusions: Manometric examination does not help us to understand the mechanism of preoperative dysphagia, nor does it predict who will develop dysphagia postoperatively.