Thermoablative Techniques to Treat Excessive Central Airway Collapse

Gangadharan, Sidhu; Mathew, F.R.C.P. Ninan T.

doi:10.1016/j.thorsurg.2023.04.016

Cited by 6 publications

(1 citation statement)

References 45 publications

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“…Many studies have been written on this topic, but none of them describe the influence of the proximal esophagus on the respiratory thoracic aperture, as well as for the Empey index values over 10 in these patients [11,33]. This index rises as the obstruction becomes more severe [34]. This is one more reason to keep in mind achalasia in differential diagnoses.…”

Section: Discussionmentioning

confidence: 99%

Influence of Achalasia on the Spirometry Flow–Volume Curve and Peak Expiratory Flow

Jankovic,

Milenkovic,

Simic

et al. 2024

Diagnostics

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Background: Achalasia is an esophageal motor disorder characterized by aperistalsis and the failure of the relaxation of the lower esophageal sphincter. We want to find out whether external compression or recurrent micro-aspiration of undigested food has a functional effect on the airway. Methods: The aim of this research was to analyze the influence of achalasia on the peak expiratory flow and flow–volume curve. All of the 110 patients performed spirometry. Results: The mean diameter of the esophagus was 5.4 ± 2.1 cm, and nine of the patients had mega-esophagus. Seven patients had a plateau in the inspiratory part of the flow–volume curve, which coincides with the patients who had mega-esophagus. The rest of the patients had a plateau in the expiration part of the curve. The existence of a plateau in the diameter of the esophagus of more than 5 cm was significant (p 0.003). Statistical significance between the existence of a plateau and a lowered PEF (PEF < 80) has been proven (p 0.001). Also, a statistical significance between the subtype and diameter of more than 4 cm has been proved. There was no significant improvement in the PEF values after operation. In total, 20.9% of patients had a spirometry abnormality finding. The frequency of the improvement in the spirometry values after surgery did not differ significantly by achalasia subtype. The improvement in FEV1 was statistically significant compared to the FVC values. Conclusions: Awareness of the influence of achalasia on the pulmonary parameters is important because low values of PEF with a plateau on the spirometry loop can lead to misdiagnosis. The recognition of various patterns of the spirometry loop may help in identifying airway obstruction caused by another non-pulmonary disease such as achalasia.

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Section: Discussionmentioning

confidence: 99%