Intestinal pacing for canine postgastrectomy dumping.
Our aim was to determine whether or not postprandial retrograde duodenal pacing would abolish the canine postgastrectomy dumping syndrome. Five dogs underwent truncal vagotomy, distal hemigastrectomy, gastroduodenostomy, and circumferential proximal duodenal myotomy to facilitate pacing. Bipolar stimulating electrodes from an implanted pacing unit were attached to the bowel 35 cm distal to the gastroduodenostomy, and six monopolar recording electrodes were applied at 5-cm intervals proximal to the pacing electrodes. After recovery, gastric emptying was assessed in the fasted conscious dogs using 300-ml gastric instillates of 25% dextrose marked with [14C]polyethylene glycol, while pulse, hematocrit, and defecation were monitored. Each dog underwent five tests with and five tests without retrograde duodenal pacing. Without pacing, the dogs emptied a mean +/- SEM of 237 +/- 14 ml of the instillate by 20 min and developed tachycardia (change in pulse, 45 +/- 4), hemoconcentration (change in hematocrit, 8 +/- 1), and diarrhea in 13 of 25 tests. Retrograde duodenal pacing slowed gastric emptying (157 +/- 20 ml, p less than 0.05) and minimized the adverse cardiovascular sequelae (change in pulse, 25 +/- 5, change in hematocrit, 6 +/- 1; p less than 0.05) and the diarrhea (only 2 of 25 tests, p less than 0.01). We concluded that intestinal pacing ameliorated the postgastrectomy dumping syndrome in dogs. Such an approach may be applicable to humans.
D000200:Action Potentials; D000818:Animals; D003967:Diarrhea / Q000517:prevention & control; D004285:Dogs; D004377:Dumping Syndrome / Q000517:prevention & control*; D004386:Duodenum / Q000502:physiology*; D004599:Electric Stimulation Therapy; D004567:Electrodes, Implanted; D005260:Female; D005746:Gastric Emptying; D005769:Gastrointestinal Motility; D006400:Hematocrit; D009119:Muscle Contraction; D009130:Muscle, Smooth / Q000502:physiology; D011674:Pulse