title: Validation of the paracetamol absorption test for measuring gastric tube emptying in esophagectomized patients versus gold standard scintigraphy.
abstract: OBJECTIVE
  Scintigraphy is the gold standard for objective measurement of delayed gastric tube emptying after esophagectomy. The aim of this pilot study is to validate, by reference to scintigraphy, the paracetamol absorption test for measuring gastric tube emptying in esophagectomized patients.
  
  
  METHODS
  The paracetamol absorption test and scintigraphy were performed simultaneously in 13 patients who had undergone an esophagectomy with gastric tube reconstruction. Emptying was calculated for both methods and compared. Post-esophagectomy symptoms and quality of life (QoL) were assessed by European Organization on Research and Treatment of Cancer questionnaires.
  
  
  RESULTS
  Mean time to 50% emptying was 17 min measured with the paracetamol absorption test and 23 min with scintigraphy. For time to 25% emptying, Bland-Altman calculation gave a bias of 1.6 min and 95% limits of agreement (LoA) of -6.3 to 9.5 min. For time to 50% emptying, there was one outlier resulting in a bias of -6.33 min and 95% LoA of -36.4 to 23.8 min. For time to 75% emptying, bias was -11.6 min and 95% LoA of -38.5 to 15.4 min. Post-esophagectomy symptoms were similar to those reported previously, and QoL was comparable to the general Swedish population.
  
  
  CONCLUSIONS
  There was reasonably close correlation between the paracetamol absorption test and scintigraphy for time to 25% and 50% emptying, except for one outlier. For time to 75% emptying the methods were in less accordance. The results indicate that the paracetamol absorption test may be a useful screening tool for identifying delayed gastric tube emptying in this patient group.
authors.affiliation: Department of Surgery, Lund University, Skåne University Hospital , Lund , Sweden.
authors.forename: Pauline
authors.initials: P
authors.lastname: Djerf
authors.forename: Martin
authors.initials: M
authors.lastname: Brundin
authors.forename: Marika
authors.initials: M
authors.lastname: Bajk
authors.forename: Ulrika
authors.initials: U
authors.lastname: Smedh
mesh_terms: D000082:Acetaminophen / Q000097:blood*; D000368:Aged; D000369:Aged, 80 and over; D016629:Esophagectomy; D005260:Female; D005746:Gastric Emptying; D006801:Humans; D007408:Intestinal Absorption; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011788:Quality of Life; D011877:Radionuclide Imaging / Q000592:standards*; D013270:Stomach / Q000000981:diagnostic imaging*; D011795:Surveys and Questionnaires
chemical_list: D000082:Acetaminophen
keywords: esophagectomy; gastric emptying; paracetamol; scintigraphy; validation study