title: Postoperative reorganization of gastric pacemaker activity in patients after an extended period following distal gastrectomy.
abstract: We recorded and analyzed electrogastrograms (EGGs) from 12 patients following distal gastrectomy. The EGGs were recorded from between 3 and 262 months post-operatively. Gastric electrical activity, which showed a distinct repeating pattern with a frequency of 3 cycles per minute (cpm), was easily recognizable in subjects who were recorded 16-20 years postoperatively, but was not clearly evident in EGG running spectra of subjects with a shorter postoperative period. Although the postprandial instability factor of the 3-cpm components (standard deviation of mean spectral frequency of peak 3-cpm group/mean of the 3-cpm spectral frequency) of the epigastric and supraumbilical EGGs showed a significant negative linear correlation with postoperative months, no such correlation was seen in the postprandial to fasting power ratio (postprandial power / fasting power) of the 3-cpm activity component. Therefore, we hypothesized that the disorganized pacemaker activity of the remnant stomach following distal gastrectomy can be reorganized to work as a synchronized unit over a long postoperative recovery period of from 15 to 20 years. A greater degree of epigastric and supraumbilical fasting 6-cpm power seemed to result in a worse quality of life (QOL). Similarly, a larger ratio of the supraumbilical postprandial to fasting power ratio of the 6-cpm activity seemed to result in a worse QOL. In contrast a larger ratio of the infaraumbilical postprandial to fasting power content of the 6-cpm activity seemed to result in a better QOL.
authors.affiliation: Division of Organ Physiology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan. sjnhomma@sin-ai.jp
authors.forename: Shinji
authors.initials: S
authors.lastname: Homma
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Shinichi
authors.initials: S
authors.lastname: Kosugi
authors.forename: Manabu
authors.initials: M
authors.lastname: Ohashi
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Kanda
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Okamoto
authors.forename: Katsuyoshi
authors.initials: K
authors.lastname: Hatakeyama
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001683:Biological Clocks / Q000502:physiology*; D055724:Electrophysiological Phenomena / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods*; D041981:Gastrointestinal Tract / Q000166:cytology / Q000294:innervation / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D032389:Myocytes, Smooth Muscle / Q000166:cytology / Q000502:physiology; D019518:Postprandial Period / Q000502:physiology; D011788:Quality of Life; D013270:Stomach / Q000294:innervation* / Q000502:physiology* / Q000601:surgery; D013997:Time Factors