Abstract
Manometric studies were carried out for thirteen cases of pharyngoesophageal reconstruction with free transplantation of jejunal segments in order to evaluate intermittent dysphagia during the early postoperative period. The following results were obtained.1. Dysphagia was observed when transplanted jejunum made spontaneous continuous contractions, and it disappeared after the contractions were subsided.2. Continuous waves were observed for 13.0% of the testing period with the duration of 3.6±3.5 minutes. The average value of the maximum pressure for the continuous waves were 109.7±72.5cm H2O. The average rate of the wave was 10.9±1.8 times per minute in interdigestive period.3. The shorter the postoperative period was, the shorter the duration of continuous waves was in operated cases.4. The continuous jejunal waves after swallowing were observed more frequently for the cases whose postoperative periods were within two months than for other cases. The waves were thought to be a disadvantage for oral intake.5. Almost all of the continuous jejunai waves after 5 months of postoperative periods were similar to normal interdigestive jejunal strong contractions (interdigestive myo-electric complex; IMEC).From these results and the facts that interdigestive myo-electric complex (IMEC) is not triggered by swallowing and that they disappear immediately after feeding, it is suggested that dysphagia or nasal regurgitation observed in the early postoperative period for the cases of free jejunal transplantation is related to irregular jejunal movements which is different from normal IMEC.
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