1995 Fiscal Year Final Research Report Summary
Pathophysiological Elucidation of Reflux Esophagitis after Gastrectomy and Establishment of Reconstruction and Treatment Techniques
| Project/Area Number |
05671091
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| Research Category |
Grant-in-Aid for General Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Research Field |
Digestive surgery
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| Research Institution | Jikei University School of Medicine |
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Principal Investigator |
MORITA Sigeo JIKEI UNIVERSITY SCHOOL OF MEDICINE,assistant, 外科2, 助手 (90246447)
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| 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)
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| Project Period (FY) |
1993 – 1995
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| Keywords | Reflux esophagitis after gastrectomy / intraesophageal pressure measurement |
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| 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.
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