Gastric myoelectrical activity post-chemoradiotherapy and esophagectomy: a prospective study using subscapular surface recording.
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.
Lawlor
P M
PM
GI Function Unit, St James Hospital, Dublin 8, Ireland.
McCullough
J A
JA
Byrne
P J
PJ
Reynolds
J V
JV
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