Evaluation of electrical activity after vagus nerve-preserving distal gastrectomy using multichannel electrogastrography
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概要
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Background: Multichannel electrogastrography (M-EGG) can be used to evaluate gastrointestinal motility. The myoelectric activity of the remnant stomach after surgery has not been measured by M-EGG. This study examined whether myoelectric activity varied with surgical technique and compared vagus nerve-preserving distal gastrectomy (VP-DG) with standard distal gastrectomy without vagus nerve preservation (DG). Furthermore, we examined the relationship between the M-EGG findings and patients' postoperative symptoms.Methods: Twenty-six patients who underwent VP-DG, 20 who underwent DG, and 12 healthy volunteers as controls were examined with M-EGG. The Gastrointestinal Symptom Rating Scale (GSRS) was used to assess postoperative symptoms.Results: Longer periods of normal gastric function (normogastria, 2.0–4.0 cycle min–1) were detected in channel 1 in the VP-DG group than in the DG group in either the fasted or fed state (P<0.05). The percentage of slow wave coupling (%SWC) in the fed state correlated negatively with GSRS scores (reflux, r=–0.59, P=0.02; abdominal pain, r=–0.51, P=0.04, indigestion, r=–0.59, P=0.02 and total score, r=–0.75, P=0.02).Conclusions: Slow waves can be recorded non-invasively using M-EGG in the remnant stomach following gastrectomy. The VP-DG group showed better preserved gastric myoelectric activity than the DG group, and the %SWC showed a significant negative correlation with scores of GSRS (reflux, abdominal pain, indigestion and total score) in the VP-DG group.
著者
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Nakamura Masafumi
Department Of Cancer Therapy And Research Graduate School Of Medical Sciences Kyushu University
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Higashida Masaharu
Department Of Pediatrics2 Kawasaki Medical School
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Matsumoto Hideo
Department Of Anesthesiology Kansai Medical University
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Kubota Hisako
Department Of Life Sciences (biology) Graduate School Of Arts And Science University Of Tokyo
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HIRAI Toshihiro
Department of Gastroenterological Surgery, Kawasaki Medical School
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Nakamura Masafumi
Department of Digestive Surgery, Kawasaki Medical School, Japan
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Murakami Haruaki
Department of Digestive Surgery, Kawasaki Medical School, Japan
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Hirai Toshihiro
Department of Digestive Surgery, Kawasaki Medical School, Japan
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Higashida Masaharu
Department of Digestive Surgery, Kawasaki Medical School, Japan
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