Morphological changes in the lower esophageal sphincter influencing the result of antireflux surgical interventions in chronic gastroesophageal reflux disease

Áron Altorjay, Anna Szilagyi, Gabriella Arato, Balazs Paal, Arpad Juhasz, Gabor Kecskes, I. Altorjay, J. Kiss, Pal Nagy

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background/Aims: It is still unclear whether long-term reflux episodes result in morphological changes in the lower esophageal sphincter or not. If the answer is supposedly yes, do these changes influence the postoperative functional results following antireflux surgery? Methodology: Between 1 January 2002 and 2004, we performed antireflux surgery on 85 patients. Muscle samples were taken from the lower esophageal sphincter (LES) in 57 patients on operation. Patients with endoscopic findings of moderate or severe reflux esophagitis - Los Angeles B, C, D - were excluded. Control samples were obtained from muscle tissue at the gastroesophageal junction that had been removed from 16 patients undergoing gastric or esophageal resection. Histologic (hematoxylin & eosin and Giemsa), and immunohistologic (S-100 Protein, NCL-SERCA2, α-SMA) and electronmicroscopic analysis were used to evaluate the specimens. The number of smooth muscle cell nuclei in these intraoperative biopsies was used to compare the results of antireflux operations (Visick I and II-III). Results: In 19% (11/57) of the reflux-type LES muscle samples perivascular inflammatory infiltration has been noted and in 6 of these cases (6/57=11%) this has incorporated marked intramuscular and adventitial granulocyte infiltration. In one patient (1/57 = 2%) eosinophil infiltration of the myenteric plexus and the ganglion has been revealed. Significantly lower Schwann and smooth muscle cell count could be detected in LES muscle samples taken from patients with GERD (p

Original languageEnglish
Pages (from-to)342-347
Number of pages6
JournalHepato-Gastroenterology
Volume53
Issue number69
Publication statusPublished - May 2006

Fingerprint

Lower Esophageal Sphincter
Gastroesophageal Reflux
Muscles
Smooth Muscle Myocytes
Esophagogastric Junction
Myenteric Plexus
Adventitia
Peptic Esophagitis
Los Angeles
S100 Proteins
Hematoxylin
Eosine Yellowish-(YS)
Cell Nucleus
Granulocytes
Eosinophils
Ganglia
Stomach
Cell Count
Biopsy

Keywords

  • Anti-reflux surgery
  • Dysphagia
  • Enteric ganglionitis
  • Gastroesophageal reflux
  • Hypertrophy
  • LES muscle
  • Morphology
  • Panmural esophagitis

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Morphological changes in the lower esophageal sphincter influencing the result of antireflux surgical interventions in chronic gastroesophageal reflux disease. / Altorjay, Áron; Szilagyi, Anna; Arato, Gabriella; Paal, Balazs; Juhasz, Arpad; Kecskes, Gabor; Altorjay, I.; Kiss, J.; Nagy, Pal.

In: Hepato-Gastroenterology, Vol. 53, No. 69, 05.2006, p. 342-347.

Research output: Contribution to journalArticle

Altorjay, Áron ; Szilagyi, Anna ; Arato, Gabriella ; Paal, Balazs ; Juhasz, Arpad ; Kecskes, Gabor ; Altorjay, I. ; Kiss, J. ; Nagy, Pal. / Morphological changes in the lower esophageal sphincter influencing the result of antireflux surgical interventions in chronic gastroesophageal reflux disease. In: Hepato-Gastroenterology. 2006 ; Vol. 53, No. 69. pp. 342-347.
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AU - Szilagyi, Anna

AU - Arato, Gabriella

AU - Paal, Balazs

AU - Juhasz, Arpad

AU - Kecskes, Gabor

AU - Altorjay, I.

AU - Kiss, J.

AU - Nagy, Pal

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