Zheng Wei, Zhou Lun, Lin Peiqiu, Lin Ruobai, Chen Chun, Kang Mingqiang, Lin Ying
Department of Thoracic Surgery, Affiliated Union Hospital, Fujian Medical University, Fuzhou 350001, China.
Zhonghua Wai Ke Za Zhi. 2002 Jul;40(7):511-4.
To study the mechanism of delayed emptying indigestible solids in thoracic stomach after the resection of esophageal cancer by monitoring the variety of antropyloroduodenal migrating motor complex (MMC) during interdigestion.
Esophagectomy and gastroesophagostomy in the neck was performed in 5 men with esophageal cancer. An eight-lumen manometric sleeve assembly was passed through a nostril into the duodenum during operation. The sleeve was astride the pylorus. Antropyloroduodenal manometry was performed for at least 300 min with a polygraphic system (PC POLYGRAF HR) 7 - 11 days after operation.
Twenty-eight MMCs were recorded in the pylorus and duodenum, 12 MMC(s) in the antrum, and 33% (4/12) of the motility frequency of antral phases III started after that of pyloroduodenal phases III. The number of MMC in the antrum was lower than that in the duodenum after the operation. The mean duration of MMC of the antrum, pylorus and duodenum was (49.2 +/- 10.5) min, (46.5 +/- 10.4) min and (45.9 +/- 10.0) min respectively. The mean duration of phases III was respectively (6.7 +/- 3.5) min in the antrum, (10.0 +/- 3.5) min in pylorus, and (8.0 +/- 3.9) min in duodenum. The mean wave amplitude of phases III was respectively (83 +/- 30) mm Hg in the antrum, (60 +/- 12) mm Hg in pylorus, and (55 +/- 4) mm Hg in duodenum. The mean duration of MMC of the antrum and duodenum was shorter in patients than that in healthy volunteers, and the mean wave amplitude of phases III of the antrum was lower in patients than that in healthy volunteers.
Diminution of the number of MMC and the mean wave amplitude of phases III in the antrum, incoordination of the antropyloroduodenal phases III should be the most important one of the mechanisms of delayed emptying of indigestible solids in thoracic stomach after the resection of esophageal cancer.
通过监测消化间期胃十二指肠移行性复合运动（MMC）的变化，研究食管癌切除术后胸胃内难消化固体排空延迟的机制。
对5例男性食管癌患者行食管癌切除并颈部食管胃吻合术。术中将一个八腔测压套管组件经鼻孔插入十二指肠，套管跨过幽门。术后7～11天，使用多导生理记录仪（PC POLYGRAF HR）进行胃十二指肠测压至少300分钟。
在幽门和十二指肠记录到28次MMC，胃窦部记录到12次MMC，胃窦部Ⅲ相运动频率的33%（4/12）在幽门十二指肠Ⅲ相运动频率之后开始。术后胃窦部MMC的数量低于十二指肠。胃窦部、幽门和十二指肠MMC的平均持续时间分别为（49.2±10.5）分钟、（46.5±10.4）分钟和（45.9±10.0）分钟。Ⅲ相的平均持续时间在胃窦部为（6.7±3.5）分钟，在幽门为（10.0±3.5）分钟，在十二指肠为（8.0±3.9）分钟。Ⅲ相的平均波幅在胃窦部为（83±30）mmHg，在幽门为（60±12）mmHg，在十二指肠为（55±4）mmHg。患者胃窦部和十二指肠MMC的平均持续时间短于健康志愿者，患者胃窦部Ⅲ相的平均波幅低于健康志愿者。
胃窦部MMC数量减少、Ⅲ相平均波幅降低以及胃十二指肠Ⅲ相不协调应是食管癌切除术后胸胃内难消化固体排空延迟的最重要机制之一。
