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Pathophysiological Elucidation of Reflux Esophagitis after Gastrectomy and Establishment of Reconstruction and Treatment Techniques

Research Project

Project/Area Number 05671091
Research Category

Grant-in-Aid for General Scientific Research (C)

Allocation TypeSingle-year Grants
Research Field Digestive surgery
Research InstitutionJikei University School of Medicine

Principal Investigator

MORITA Sigeo  JIKEI UNIVERSITY SCHOOL OF MEDICINE,assistant, 外科2, 助手 (90246447)

Co-Investigator(Kenkyū-buntansha) HANYU Nobuyoshi  JIKEI UNIVERSITY SCHOOL OF MEDICINE,associate professor, 外科2, 助教授 (30189592)
ABE Sadanobu  JIKEI UNIVERSITY SCHOOL OF MEDICINE,assistant, 外科2, 助手 (60231114)
OHIRA Youichi  JIKEI UNIVERSITY SCHOOL OF MEDICINE,assistant, 外科2, 助手 (10213852)
FURUKAWA Yoshiyuki  JIKEI UNIVERSITY SCHOOL OF MEDICINE,assistant professor, 外科2, 講師 (80209171)
Project Period (FY) 1993 – 1995
Project Status Completed (Fiscal Year 1995)
Budget Amount *help
¥1,800,000 (Direct Cost: ¥1,800,000)
Fiscal Year 1995: ¥600,000 (Direct Cost: ¥600,000)
Fiscal Year 1994: ¥600,000 (Direct Cost: ¥600,000)
Fiscal Year 1993: ¥600,000 (Direct Cost: ¥600,000)
KeywordsReflux esophagitis after gastrectomy / intraesophageal pressure measurement / 胃切後障害 / 逆流性食道炎 / 胃切除術後逆流性食道炎 / 食道運動機能 / 下部食道括約筋
Research Abstract

As the ontcome of operations for gastric cancer has improved, postoperative reflux esophagiti has come to attract a great deal of attention, and damage to the area surrounding the lowe esophageal sphincter (LES) is a very serious problem. In this study, we investigated the anatomical changes in the esophagogastric junction after gastrectomy, changes in esophagea peristaltic function, and the mechanism of reflux esophagitis.
Subjects : The subjects of this study were 21 patients (13 males and 7 females) with gastric cancer who underwent pylorogastrectomy. Reconstruction was performed by the Billroth I method in every case.
Methods : Before, and two to three weeks after the operation, intraesophageal pressure and lower esophageal pressure (LESP) were recorded using the Andorfer capillary system and a Dent sleeve catheter via a pressure transducer, and the data were analyzed by computer. To assess the effect of swallowing, dry swallowing and wet swallowing were repeated ten times each.
Results : 1. Resting LESP during dry swallows and wet swallows tended to be lower postoperatively. 2. Peristaltic cantraction pressure during both dry swallows and wet swallows was significantly lower postoperatively in the upper, middle and lower esophagus. 3. The transmission velocity of contraction waves was significantly lower postoperatively during dry swallows in the upper, intermediate and lower esophagus, but no significant postoperative decreases were observed during wet swallows. These findings showed that resting LESF declines and esophageal motility is impaired after pylorogastrectomy, suggesting that changes in LES and slowed gastric emptying are the causes of reflux esophagitis.

Report

(4 results)
  • 1995 Annual Research Report   Final Research Report Summary
  • 1994 Annual Research Report
  • 1993 Annual Research Report
  • Research Products

    (9 results)

All Other

All Publications (9 results)

  • [Publications] 森田茂生: "アカラシア,逆流性食道炎のLES圧と外科治療" J.Smooth Muscle Res.27. 163-164 (1991)

    • Related Report
      1994 Annual Research Report
  • [Publications] 森田茂生: "アカラシア症例の検討" クリニカ. 20. 7-9 (1993)

    • Related Report
      1994 Annual Research Report
  • [Publications] 森田茂生: "逆流性食道炎の長期管理" 消化器科. 13. 441-444 (1990)

    • Related Report
      1994 Annual Research Report
  • [Publications] 森田茂生: "健常人の食道収縮圧,LES圧の検討" 日本平滑筋誌. 26. 345-347 (1990)

    • Related Report
      1994 Annual Research Report
  • [Publications] 森田茂生: "逆流性食道炎術後のLES圧と食道運動機能" 日本平滑筋誌. (1991)

    • Related Report
      1994 Annual Research Report
  • [Publications] 森田 茂生: "健常人の食道収縮圧,LES圧の検討" 日本平滑筋誌. 20. 345-347 (1990)

    • Related Report
      1993 Annual Research Report
  • [Publications] 森田 茂生: "逆流性食道炎の長期管理-手術症例からの検討" 消化器科. 13. 441-444 (1990)

    • Related Report
      1993 Annual Research Report
  • [Publications] 森田 茂生: "アカラシア,逆流性食道炎のLES圧と外科治療" 日本平滑筋誌. 27. 163-1991 (1991)

    • Related Report
      1993 Annual Research Report
  • [Publications] 森田 茂生: "アカラシアの病態" 日本平滑筋誌. 29. 191-194 (1993)

    • Related Report
      1993 Annual Research Report

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Published: 1993-04-01   Modified: 2016-04-21  

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