Hill A D, Walsh T N, Hamilton D, Freyne P, O'Hare N, Byrne P J, Hennessy T P
University Department of Surgery, St James's Hospital, Dublin, Ireland.
Br J Surg. 1993 Jul;80(7):879-81. doi: 10.1002/bjs.1800800726.
Oesophagectomy, necessitating vagotomy, is associated with delayed gastric emptying. Cisapride and erythromycin have prokinetic effects and improve emptying of the innervated stomach. Their effect on the denervated stomach following oesophagectomy is unknown. The effect of pyloroplasty, cisapride and erythromycin on the rate of gastric emptying after oesophagectomy was studied using a radiolabelled meal. Oesophagectomy was associated with a marked delay in gastric emptying (56 per cent of the test meal remaining after 4 h) compared with age- and sex-matched normal controls (16 per cent; P < 0.001). Erythromycin improved the rate of gastric emptying to preoperative control values (18 per cent). Cisapride had no significant effect on gastric emptying. After pyloroplasty, 32 per cent of the label remained at 4 h (P = 0.065). The mean(s.e.m.) half-emptying time in patients receiving erythromycin was 94(29) min, which was similar to control values, 55(3) min (P = 0.26). Erythromycin may have a role in the treatment of gastric stasis following oesophagectomy or truncal vagotomy.
需要进行迷走神经切断术的食管切除术与胃排空延迟有关。西沙必利和红霉素具有促动力作用，可改善受神经支配胃的排空。它们对食管切除术后去神经支配胃的影响尚不清楚。使用放射性标记餐研究了幽门成形术、西沙必利和红霉素对食管切除术后胃排空率的影响。与年龄和性别匹配的正常对照组（16%；P<0.001）相比，食管切除术与胃排空明显延迟有关（4小时后仍有56%的试验餐残留）。红霉素将胃排空率提高到术前对照值（18%）。西沙必利对胃排空无显著影响。幽门成形术后，4小时时有32%的标记物残留（P=0.065）。接受红霉素治疗的患者平均（标准误）半排空时间为94（29）分钟，与对照值55（3）分钟相似（P=0.26）。红霉素可能在治疗食管切除术或迷走神经干切断术后的胃潴留中发挥作用。
