Disturbed esophageal motility after total gastrectomy.
Esophageal manometry with a catheter microtransducer was performed as a functional diagnostic method on 30 patients after total gastrectomy because of gastric cancer (18 men, 12 women with a mean age of 64 +/- 3.7 years). Subsequently their symptoms were recorded. 21 of the patients (70%) complained of reflux discomfort and symptoms of disturbed peristalsis (dysphagia, odynophagia). 29 patients (93%) showed pathological patterns of contraction (repetitive, simultaneous, deformed, multipeak contractions) especially in the distal part of the esophagus. The contractile force was decreased on average by 10 mmHg in that area. The resting pressure of the upper sphincter was also decreased by about 10 mmHg. These results can be explained by an increased postoperative reflux (absence of the lower sphincter) and the changed biomechanics of the esophagus (decreased longitudinal tension) caused by the operation. The results of this study demonstrate the importance of postoperative manometry in total gastrectomized patients.
Surgical Clinic, University of Luebeck, Germany.
R
R
Broll
G
G
Müller
C
C
Bürk
P
P
Stefanovich
H P
HP
Bruch
D000230:Adenocarcinoma / Q000601:surgery*; D002288:Adenocarcinoma, Mucinous / Q000601:surgery*; D000328:Adult; D000368:Aged; D000713:Anastomosis, Roux-en-Y; D001696:Biomechanical Phenomena; D015154:Esophageal Motility Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D004946:Esophagostomy; D004947:Esophagus / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D007582:Jejunostomy; D007583:Jejunum / Q000601:surgery*; D008223:Lymphoma / Q000601:surgery*; D008297:Male; D008365:Manometry / Q000295:instrumentation / Q000379:methods; D008875:Middle Aged; D010528:Peristalsis; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000601:surgery*