Disturbed esophageal motility after total gastrectomy

Area of Science:

• Gastroenterology
• Surgical Oncology
• Diagnostic Medicine

Background:

• Total gastrectomy for gastric cancer significantly alters upper gastrointestinal anatomy and physiology.
• Postoperative complications can include esophageal dysfunction and reflux, impacting patient quality of life.

Purpose of the Study:

• To evaluate esophageal motility and pressure dynamics using manometry in patients following total gastrectomy.
• To correlate manometric findings with patient-reported symptoms of esophageal dysfunction.

Main Methods:

• Esophageal manometry utilizing a catheter microtransducer was performed on 30 patients post-total gastrectomy.
• Patient symptoms including reflux, dysphagia, and odynophagia were systematically recorded.

Main Results:

• 70% of patients reported symptoms of reflux and disturbed peristalsis (dysphagia, odynophagia).
• 93% exhibited abnormal esophageal contractions (repetitive, simultaneous, deformed, multipeak), particularly distally.
• Mean esophageal contractile force and upper esophageal sphincter resting pressure decreased by approximately 10 mmHg.

Conclusions:

• Postoperative reflux and altered esophageal biomechanics contribute to manometric abnormalities after total gastrectomy.
• Esophageal manometry is crucial for diagnosing functional changes and guiding management in post-gastrectomy patients.