The Japanese journal of surgery

, Volume 18, Issue 2, pp 218–223 | Cite as

Esophageal manometrical assessment after esophageal circular myotomy for wide-gap esophageal atresia

  • Kenzo Sumitomo
  • Keiichi Ikeda
  • Akira Nagasaki
Case Reports


We treated 3 children with wide-gap esophageal atresia by a circular myotomy of Livaditis technique, after which no postoperative complaints, such as heartburn, vomiting or dysphagia, were seen. Esophageal manometry, performed to evaluate the postoperative esophageal motor function revealed; (1) that lower esophageal sphincter pressure (LESP) increased gradually with time, (2) esophageal contraction waves (ECW) were evident at the site of the circular myotomy with swallowing, though these contractions were simultaneous; and (3) relaxation of the LES with swallowing was evident. These findings, as determined by the esophageal manometrical assessments, indicate that there is no difference between the postoperative esophageal function after either repair with a circular myotomy or primary anastomosis for esophageal atresia.

Key words

Livaditis’ technique circular myotomy esophageal atresia esophageal manometry 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Livaditis A. Esophageal atresia: A method of overbridging large segment gaps. Z Kinderchir 1973; 13: 298–306.Google Scholar
  2. 2.
    Rehbein F, Schweder N. Neue Wege in der Reconstruktion der kindlichen Speiserohre. Dtsch Med Wshr 1972; 79: 757.CrossRefGoogle Scholar
  3. 3.
    Shepard R, Fenn S, Sieber WK. Evaluation of esophageal function in postoperative esophageal atresia and tracheoesophageal fistula. Surg 1966; 59: 608–617.Google Scholar
  4. 4.
    Lind JF, Blanchard RJ, Guyda H. Esophageal motility in tracheoesophageal fistula and esophageal atresia. surg Gynecol Obstet 1966; 123: 557–564.PubMedGoogle Scholar
  5. 5.
    Duranceau A, Fisher SR, Flye MW, Jones RS, Postlethwait RW, Sealy WC. Motor function of the esophagus after repair of esophageal atresia and tracheoesophageal fistula. Surg 1977; 82: 116–123.Google Scholar
  6. 6.
    Whitington PE, Shermata DW, Seto DSY, Jones L, Hendrix TR. Role of lower esophageal sphincter incompetence in recurrent pneumonia after repair of esophageal atresia. J Pediatr 1977; 91: 550–554.PubMedCrossRefGoogle Scholar
  7. 7.
    Orringer MB, Kirsh MM, Sloan H. Long-term esophageal function following repair of esophageal atresia. Ann Surg 1977; 186: 436–443.PubMedGoogle Scholar
  8. 8.
    Wearlin SL, Dodds WJ, Hogan WJ, Glicklich M, Arndorfer R. Esophageal function in esophageal atresia. Dig Dis Sci 1981; 26: 796–800.CrossRefGoogle Scholar
  9. 9.
    Carveth SW, Schlegel JF, Code CF, Ellis FH Jr. Esophageal motility after vagotomy, phrenicotomy, myotomy, and myomectomy in dogs. Surg Gynecol Obstet 1962; 114: 31–42.PubMedGoogle Scholar
  10. 10.
    Hankins JR, Ormsbee HS, McLaughlin JS. Circular esophageal myotomy in rhesus monkey: Anatomical and physiological effects. Ann Thorac Surg 1983; 36: 258–264.PubMedCrossRefGoogle Scholar
  11. 11.
    Nakada K, Shimoyamada H, Arase K, Ishikawa M, Fujioka T, Saegusa T, Enami T, Kitagawa H, Noguchi T. Experiences with circular esophagomyotomy for primary anastomosis of wide-gap esophageal atresia (Livaditis). Nihon Shonigeka Gakukai Zasshi (J Jpn Soc Pediatr Surg) 1982; 18: 1209–1218. (English Abst.)Google Scholar
  12. 12.
    Eraklis AJ, Rossello PJ, Ballatine TVN. Circular esophagomyotomy of upper pouch in primary repair of long segment esophageal atresia. J Pediatr Surg 1976; 11: 709–712.PubMedCrossRefGoogle Scholar
  13. 13.
    Slim MS. Circular myotomy of the esophagus. Clinical application in esophageal atresia. Ann Thorac Surg 1977; 23: 62–67.PubMedCrossRefGoogle Scholar

Copyright information

© The Japan Surgical Society 1988

Authors and Affiliations

  • Kenzo Sumitomo
    • 1
  • Keiichi Ikeda
    • 1
  • Akira Nagasaki
    • 1
  1. 1.Department of Pediatric Surgery, Faculty of MedicineKyushu UniversityFukuokaJapan

Personalised recommendations