Clinical Research
Copyright ©2005 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 28, 2005; 11(8): 1172-1178
Published online Feb 28, 2005. doi: 10.3748/wjg.v11.i8.1172
Synchronous electrogastrographic and manometric study of the stomach as an esophageal substitute
Ferenc Izbéki, Tibor Wittmann, Sándor Ódor, Balázs Botos, Áron Altorjay
Ferenc Izbéki, Tibor Wittmann, Department of Medicine, University of Szeged, Szeged, Korányi fasor 8-10, H-6720, Hungary
Sándor Ódor, Department of Medicine, Saint George University Teaching Hospital, Székesfehérvár, Seregélyesi u. 3., H-8000, Hungary
Balázs Botos, Áron Altorjay, Department of Surgery, Saint George University Teaching Hospital, Székesfehérvár, Seregélyesi u. 3., H-8000, Hungary
Author contributions: All authors contributed equally to the work.
Correspondence to: Áron Altorjay M.D., Ph.D., Professor of Surgery, Department of Surgery, Saint George University Teaching Hospital, Seregélyesi u. 3., Székesfehérvár, H-8000, Hungary.
Telephone: +36-22-504-100 Fax: +36-22-504-100
Received: July 17, 2004
Revised: July 20, 2004
Accepted: September 19, 2004
Published online: February 28, 2005

AIM: To investigate the electric and contractile mechanisms involved in the deranged function of the transposed stomach in relation to the course of the symptoms and the changes in contractile and electrical parameters over time.

METHODS: Twenty-one patients after subtotal esoph-agectomy and 18 healthy volunteers were studied. Complaints were compiled by using a questionnaire, and a symptom score was formed. Synchronous electrogas-trography and gastric manometry were performed in the fasting state and postprandially.

RESULTS: Eight of the operated patients were symptom-free and 13 had symptoms. The durations of the postoperative periods for the symptomatic (9.1±6.5 mo) and the asymptomatic (28.3±8.8 mo) patients were significantly different. The symptom score correlated negatively with the time that had elapsed since the operation. The percentages of the dominant frequency in the normogastric, bradygastric and tachygastric ranges differed significantly between the controls and the patients. A significant difference was detected between the power ratio of the controls and that of the patients. The occurrence of tachygastria in the symptomatic and the symptom-free patients correlated negatively both with the time that had elapsed and with the symptom score. There was a significant increase in motility index after feeding in the controls, but not in the patients. The contractile activity of the stomach increased both in the controls and in the symptom-free patients. In contrast, in the group of symptomatic patients, the contractile activity decreased postprandially as compared with the fasting state.

CONCLUSION: The patients’ post-operative complaints and symptoms change during the post-operative period and correlate with the parameters of the myoelectric and contractile activities of the stomach. Tachygastria seems to be the major pathogenetic factor involved in the contractile dysfunction.

Keywords: Transposed stomach, Electrogastrography, Gastric manometry, Post-operative complaints, Contractile dysfunction, Tachygastria