WANG Jin dong , LIU JunJeng , WANG Qi zhang , et al .
  • WANG Jin dong, LIU Jun-Jeng, WANG Qi zhang, LI Bao qing, TIAN Zi-qiang. Department of Thoracic Surgery, the Fourth Hospital, Hebei Medical University, Shijiazhuang 050011, Hebei , P. R. China） Correspondence author ： LIU Jun feng , E-mail ：liujf@heinfo. net;
Esophagogastrostomy; Gastroesophageal reflux; Motility of the esophagus and stomach
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Objective To investigate the effect on motility function of remnant esophagus and intrathoracic stomach after esophagectomy for esophageal and cardiac carcinoma. Methods Thirty nine patients with esophageal and cardiac carcinoma were divided into two groups according to surgical procedure. Group of anastomosis above aortic arch （n = 21）： esophagogastrostomy was performed above the aortic arch in patients with esophageal carcinoma of the middle third; group of anastomosis below aortic arch（n= 18）： esophagogastrostomy was performed below the aortic arch in patients with esophageal carcinoma of the low third and cardiac carcinoma. Six health volunteers without gastroesophageal reflux were recruited as control group. Esophageal manometry and upper alimentary tract roentgenography were performed in all patients. Results There was a high pressure zone at the anastomotic orifice in parts of patients of both anastomosis groups. The resting pressure of remnant esophagus was higher than that in control group （P〈0. 05）, and similar to the resting pressure of intrathoracic stomach （P〉0. 05）. There was no significant difference in resting pressure of remnant esophagus and intrathoracic stomach between two anastomosis groups （P〉0.05）. The amplitude and number of primary peristalsis in remnant esophagus of group of anastomosis above aortic arch were significantly reduced in comparison with control group. The number of primary peristalsis in remnant esophagus of group of anastomosis above aortic arch was significantly lower than that of group of anastomosis below aortic arch （P〈0. 05）. The motility in the body of intrathoracic stomach was not observed. Weak motor activity of the gastric antrum was observed with upper alimentary tract roentgenography after surgery and evidently recovered 1 year after surgery. Conclusions The resting pressure of remnant esophagus and intrathoracic stomach is not influenced by the site of anastomosis. Esophagogastric anastomosis at the upper thorax is likely to result in poor motility of remnant esophagus. The motor activity of intrathoracic stomach becomes weak after esophagectomy and then recovers gradually over time, hut still fail to return to normal level.

Citation： WANG Jin dong,LIU JunJeng,WANG Qi zhang,et al .. Motility Function of the Remnant Esophagus and lntrathoracic Stomach after Esophagectomy for Cancer. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2006, 13(1): 21-24. doi: Copy