Gastropyloric motor activity and the effects of erythromycin given orally after esophagectomy.
BACKGROUND
The motor activity of the gastric tube as an esophageal replacement after esophagectomy is poorly understood. The aims of the present study were to examine the gastropyloric motility of the gastric tube and the effects of erythromycin given orally.


METHODS
Interdigestive gastropyloric motility was recorded by manometry with a sleeve sensor in 23 esophagectomized patients. The 23 patients were classified into 3-, 12-, and 24-month groups according to postoperative follow-up time. Radiopaque markers were used in 8 patients to assess gastric emptying. The effects of erythromycin were studied after the patients received 600 mg during fasting and 1 g postprandially.


RESULTS
Compared with the 3-month group, the 12-month group and the 24-month group showed significantly increased pyloric and antral motility, respectively. During a fast, erythromycin induced phase III in 44.4% of the patients with more than 12 months of follow-up. In contrast to the normal subjects, esophagectomized patients showed delayed gastric emptying at 3 and 4 hours. However, erythromycin significantly accelerated gastric emptying at 1, 2, 3, and 4 hours.


CONCLUSIONS
The motor activity of the gastric tube returns towards normal in a progression over time from the pylorus cephalad. Erythromycin given orally might be used as a prokinetic agent in patients after esophagectomy.
Nakabayashi
Toshihiro
T
First Department of Surgery, Faculty of Medicine, Gunma University, 3-39-15, Showa-machi, 371-8511, Maebashi, Japan.
Mochiki
Erito
E
Garcia
Moises
M
Haga
Norihiro
N
Kato
Hiroyuki
H
Suzuki
Tomoaki
T
Asao
Takayuki
T
Kuwano
Hiroyuki
H
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D004917:Erythromycin / Q000008:administration & dosage*; D004938:Esophageal Neoplasms / Q000175:diagnosis / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005746:Gastric Emptying / Q000187:drug effects* / Q000502:physiology; D005772:Gastrointestinal Transit / Q000187:drug effects* / Q000502:physiology; D005774:Gastrostomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011336:Probability; D012016:Reference Values; D016896:Treatment Outcome
D004917:Erythromycin