Gastric motility following oesophagectomy.
The motility of the vagally denervated transposed stomach after oesophagectomy was examined by ambulatory gastric manometry and videofluoroscopy. Two groups of subjects were studied. Group 1 comprised ten patients who had undergone oesophagectomy 6-12 months previously and group 2 consisted of six normal control subjects. Studies were performed on fasting and fed subjects, and following injection of erythromycin 8 mg/kg. No distinguishable manometric wave activity was seen in either group while fasting. Feeding generated a measurable wave pattern in the patient group only. A significant increase in the mean (s.e.m.) distal wave amplitude was identified after infusion of erythromycin in both patients (34.0(15.1) versus 12.2(3.1) mmHg, P < 0.05) and controls (15.1(3.4) versus 5.0(0.0) mmHg, P = 0.05). The response to erythromycin was more rapid in patients than in controls (mean(s.e.m.) 113(16) versus 377(133) s, P < 0.05) and the effect persisted for longer (more than 1 h) in those who had undergone oesophagectomy. Videofluoroscopy confirmed purposeful motility in both the normal and vagally denervated stomach. It is concluded that the transposed stomach is a dynamic conduit. Enhancement of motility was greatest in the denervated stomach, indicative of denervation supersensitivity.
Walsh
T N
TN
Department of Surgery, St James's Hospital, Dublin, Ireland.
Caldwell
M T
MT
Fallon
C
C
McGeown
G
G
Kidney
D
D
Freyne
P
P
Byrne
P J
PJ
Hennessy
T P
TP
D004917:Erythromycin / Q000494:pharmacology; D016629:Esophagectomy; D005471:Fluoroscopy / Q000379:methods; D005769:Gastrointestinal Motility / Q000187:drug effects; D006801:Humans; D008365:Manometry; D011184:Postoperative Period; D011312:Pressure; D014741:Video Recording
D004917:Erythromycin