Functioning of the intrathoracic stomach after esophagectomy.
OBJECTIVE
To investigate acid secretion and motility of the intrathoracic stomach with truncal vagotomy after esophagectomy.


METHODS
Case-control study of patients undergoing esophagectomy, with average follow-up of 3.2 months, compared with health controls.


METHODS
Yamaguchi University School of Medicine, Kogushi, Japan.


METHODS
A random sample of 21 patients selected from 79 patients with esophageal cancer during the period from May 1988 to August 1993 received the intrathoracic stomach after subtotal esophagectomy. A control sample consisted of 14 men.


METHODS
For acid secretion, a pH probe was placed in the intrathoracic stomach to measure the average pH value (average of total monitoring values) and pH holding time (ratio of the period during which the pH value was 3 or higher based on the entire continuous monitoring periods). For motility, digestive tract scintigraphy was performed to obtain the time activity curve from the analog image observed when patients ate meals labeled with indium 111. In addition, hemorrhagic ulcers in the intrathoracic stomachs of three patients were reported.


RESULTS
A pH value below 3 was recognized after surgery, and there was no significant difference between pH values in patients and normal volunteers (average pH value, 3.9 +/- 1.5 vs 3.3 +/- 1.9; pH holding time, 52.2 +/- 20.2% vs 57.1 +/- 24.4%, respectively). The time activity curve of the intrathoracic stomach observed by scintigraphy underwent no change after surgery. Among three patients with hemorrhagic ulcers, two exhibited improvements after receiving a histamine blocker, while in the other, it was not effective.


CONCLUSIONS
Acid secretion ability and motility of the intrathoracic stomach with truncal vagotomy may be unchanged after esophagectomy.
Nishikawa
M
M
Department of Surgery II, Yamaguchi University School of Medicine, Kogushi, Japan.
Murakami
T
T
Tangoku
A
A
Hayashi
H
H
Adachi
J
J
Suzuki
T
T
D016022:Case-Control Studies; D004064:Digestive System / Q000000981:diagnostic imaging; D004938:Esophageal Neoplasms / Q000503:physiopathology / Q000601:surgery; D016629:Esophagectomy; D005260:Female; D005744:Gastric Acid / Q000378:metabolism; D005746:Gastric Emptying; D005769:Gastrointestinal Motility; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D013270:Stomach / Q000503:physiopathology*; D014628:Vagotomy