Adults with oesophaguses replaced by gastric pull-up have significantly worse levels of GI, respiratory and nutrition morbidity than found in short-gap OA closed by primary repair. Multiple factors are suggested for this, some related to the change in the position of the stomach by the surgery, such as displacement of the gastroesophageal junction. Others include delayed gastric emptying and negative intrathoracic pressure and positive intraluminal pressure in the transposed stomach. The presence of the stomach in the chest also reduces functional lung capacity.
These are much increased in this population compared to primary repair patients.
Studies also show higher levels of respiratory symptoms than for those with jejunal interpositions and primary repair.
Hannon et al. (31) reported that: