Abstract：
The lungs and esophagus have a close anatomical and physiological relationship. Over the years, reflux-induced pulmonary injury has gained wider recognition, but the full effects of pulmonary disease on esophageal function are still unknown. Intrathoracic pressure dynamics potentially affect esophageal function, especially in patients with end-stage lung disease, both obstructive and restrictive. Lung transplantation is the only viable option for patients with end-stage pulmonary disease and has provided us with a unique opportunity to study these effects as transplantation restores the intrathoracic environment. Esophageal and foregut functional testing before and after transplantation provide insights into the pathophysiology of the foregut-pulmonary axis, such as how underlying pulmonary disease and intrathoracic pressure changes affect esophageal physiology. This review summarizes the available literature and shares the research experience of a lung transplant center, covering topics such as pre- and posttransplant foregut function, esophageal motility in lung transplant recipients, immune-mediated mechanisms of graft rejection associated with gastroesophageal reflux, and the role of antireflux surgery in this population.
摘要：
肺与食管有着密切的解剖和生理关系。多年来,反流诱导的肺损伤已获得更广泛的认可，但是肺部疾病对食管功能的全面影响仍然未知。胸内压力动力学可能影响食管功能，尤其是终末期肺病患者，既阻碍又限制。肺移植是终末期肺病患者唯一可行的选择，并且为我们提供了一个独特的机会来研究这些影响，因为移植可以恢复胸腔内环境。移植前后的食管和前肠功能测试可深入了解前肠-肺轴的病理生理学，例如潜在的肺部疾病和胸内压变化如何影响食管生理。这篇综述总结了现有文献，并分享了肺移植中心的研究经验，涵盖移植前和移植后前肠功能等主题，肺移植受者的食管运动，与胃食管反流相关的移植物排斥的免疫介导机制，以及抗反流手术在这一人群中的作用。
