Preoperative predictability of the short esophagus: Endoscopic criteria

Fumiaki Yano, Rudolf J. Stadlhuber, Kazuto Tsuboi, Nitin Garg, Charles J. Filipi, Sumeet K. Mittal

Research output: Contribution to journalArticle

12 Scopus citations


Background: Short esophagus is a common cause of failure of antireflux surgery. Minimally invasive intervention for short esophagus is technically difficult. Reliable predictors of short esophagus would allow appropriate referral and better outcomes. The aim of this study is to investigate the preoperative predictability of the short esophagus in patients undergoing antireflux surgery. Methods: Eighty-five patients with Collis gastroplasty and antireflux surgery (1994-2007) at a single institution form group A. Control group (B) comprises 205 consecutive patients undergoing primary antireflux surgery (2004-2007). Retrospective review of prospectively collected data was completed. Esophageal length index (ELI) was calculated as the ratio of endoscopic esophageal length (in cm) to height (in meters). Results: Patients requiring Collis gastroplasty (group A) tend to be older while there were no significant differences in sex, height, weight, and body mass index distribution between groups. Mean endoscopic esophageal length (EEL) as measured from incisor to esophagogastric junction was significantly shorter in group A (32.4 cm) as compared with group B (36.2c m) (p < 0.0001). Esophageal length index (ELI) of less than 19.5 had 83% negative predictive value with 95% specificity. Conclusions: Patients with an ELI of less than 19.5 or with stricture have higher risk for having a short esophagus.

Original languageEnglish (US)
Pages (from-to)1308-1312
Number of pages5
JournalSurgical endoscopy
Issue number6
StatePublished - Jun 2009


  • Collis gastroplasty
  • Collis-Nissen fundoplication
  • Esophageal length index
  • Preoperative predictors
  • Short esophagus

ASJC Scopus subject areas

  • Surgery

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    Yano, F., Stadlhuber, R. J., Tsuboi, K., Garg, N., Filipi, C. J., & Mittal, S. K. (2009). Preoperative predictability of the short esophagus: Endoscopic criteria. Surgical endoscopy, 23(6), 1308-1312.