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Gastric motility following oesophagectomy
T N Walsh1, M T Caldwell, C Fallon
1Department of Surgery, St James's Hospital, Dublin, Ireland.
The British Journal of Surgery
|January 1, 1995
Summary
The transposed stomach in patients post-esophagectomy shows enhanced motility, particularly after erythromycin stimulation. This suggests denervation supersensitivity in the vagally denervated stomach.
Area of Science:
- Gastroenterology
- Surgical Research
- Physiology
Background:
- Oesophagectomy often involves vagal nerve resection, potentially impacting gastric motility.
- Understanding the functional capacity of the transposed stomach is crucial for post-surgical recovery.
Purpose of the Study:
- To investigate the motility patterns of the vagally denervated transposed stomach after oesophagectomy.
- To compare gastric motility in patients versus healthy controls.
Main Methods:
- Ambulatory gastric manometry and videofluoroscopy were used.
- Studies included fasting, fed states, and erythromycin stimulation (8 mg/kg).
- Two groups were studied: 10 post-oesophagectomy patients and 6 healthy controls.
Main Results:
- No significant fasting motility observed in either group.
- Feeding induced measurable waves only in the patient group.
- Erythromycin significantly increased distal wave amplitude in both groups, with a more rapid and prolonged response in patients.
- Videofluoroscopy confirmed purposeful motility in both normal and denervated stomachs.
Conclusions:
- The transposed stomach functions as a dynamic conduit post-oesophagectomy.
- Enhanced gastric motility in the denervated stomach suggests denervation supersensitivity.
- Vagal denervation may lead to altered, yet functional, gastric motility patterns.