title: Gastric myoelectrical activity post-chemoradiotherapy and esophagectomy: a prospective study using subscapular surface recording.
abstract: The aims of this study were to prospectively evaluate gastric function in esophageal cancer patients after chemoradiotherapy and following surgery, using cutaneous electrogastrography (EGG). Twenty-three patients with esophageal adenocarcinoma were recruited to the study. A subset of patients (n = 11) underwent neoadjuvant chemoradiotherapy and were also studied at 14 days after treatment. All patients underwent EGG studies prior to and following surgery, at 3 months postoperatively. Ten of these patients were also studied at medians of 6 months and 12 months after surgery. Twenty normal volunteers were used as controls. Post-operative EGG studies were monitored with a modified technique; the electrodes being placed in the subscapular region in the area of the transposed stomach. Following neoadjuvant treatment there was a significant increase in abnormal gastric myoelectrical activity involving changes in tachygastrias and decreased motility as measured by power ratio. Post-operatively there was a significant increase in bradygastria which persisted at 6 months but not at 12 months. There was a corresponding decrease in normogastria which persisted at 6 months and to a lesser extent at 12 months. Dominant frequency remained significantly depressed at 3, 6 and 12 months. Gastric myoelectrical activity is normal in untreated esophageal cancer. Neoadjuvant chemoradiotherapy causes a disruption to normal myoelectrical activity involving reduced motility and tachygastrias. Surgery causes a depression in dominant frequency with a reduced incidence of normogastria at 3 months and 6 months but with a tendency towards normality at 12 months.
authors.affiliation: GI Function Unit, St James Hospital, Dublin 8, Ireland.
authors.forename: P M
authors.initials: PM
authors.lastname: Lawlor
authors.forename: J A
authors.initials: JA
authors.lastname: McCullough
authors.forename: P J
authors.initials: PJ
authors.lastname: Byrne
authors.forename: J V
authors.initials: JV
authors.lastname: Reynolds
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000628:therapy*; D016022:Case-Control Studies; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D004566:Electrodes; D004938:Esophageal Neoplasms / Q000473:pathology / Q000628:therapy*; D016629:Esophagectomy / Q000379:methods*; D005260:Female; D005769:Gastrointestinal Motility / Q000502:physiology; D006801:Humans; D008297:Male; D016065:Myoelectric Complex, Migrating / Q000502:physiology*; D009367:Neoplasm Staging; D011336:Probability; D011446:Prospective Studies; D018714:Radiotherapy, Adjuvant; D012016:Reference Values; D012680:Sensitivity and Specificity