Effect of erythromycin and cisapride on emptying of the vagally denervated intrathoracic stomach.
BACKGROUND
Subsequent to esophagectomy and reconstruction among patients with esophageal cancers, the intrathoracic denervated stomach acts as a passive conduit without peristalsis.


OBJECTIVE
The study was designed to assess the impact of two prokinetic drugs viz. erythromycin and cisapride on the emptying of vagally denervated intrathoracic stomach.


METHODS
Twenty consecutive patients of carcinoma esophagus, who had undergone one stage transhiatal oesophagectomy with cervical esophagogastrostomy and were disease free at three months postoperative follow-up, were included in the study. These patients were randomised into two groups of ten each. The patients in group A received erythromycin, while patients in group B received cisapride. The gastric emptying was studied by scintigraphy, using a standard test meal containing 99m Tc sulphur colloid labelled 'IDLIS' [rice based radio labelled food] before and after the drug treatment.


RESULTS
The pre and post treatment mean gastric half emptying time of the patients in the erythromycin group was 52.6 min and 49.7 min (p > 0.1) and in cisapride group it was 53.76 and 26.4 min respectively (p < 0.05). Intergroup comparison of the difference was not statistically significant.


CONCLUSIONS
Cisapride is an effective prokinetic agent in the treatment of gastric stasis of the vagally denervated intrathoracic stomach.
Narasimhan
R
R
Department of Surgery, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh-160 012.
Mittal
B R
BR
Gupta
N M
NM
D000328:Adult; D020117:Cisapride / Q000494:pharmacology*; D004917:Erythromycin / Q000494:pharmacology*; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects*; D005260:Female; D005746:Gastric Emptying / Q000187:drug effects*; D005765:Gastrointestinal Agents / Q000494:pharmacology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018709:Statistics, Nonparametric; D013270:Stomach / Q000294:innervation*; D014628:Vagotomy / Q000009:adverse effects*
D005765:Gastrointestinal Agents; D004917:Erythromycin; D020117:Cisapride