| Objective : After esophagectomy for cancer , manypatients had the symptom of anorexia,abdominal distention,belching , reflux , diarrhoea and nausea because of thedestruction of anatomic structure and the alteration of neuraland humoral regulation.It was reported that the pathologicaland physiological changes of alimentary canal caused thesesymptoms.In this study,we observed the gastric emptying byradiopaque markers,detected the changes of motilin andgastrin level in blood,estimated the motility of the remnantesophagus by manometry , and then investigated theircorrelation.Materials and Methods:Twenty-three patients who everunderwent esophagectomy for esophageal carcinoma at theDepartment of Thoracic surgery,Fourth Hospital,HebeiMedical University between January 2004 and January 2005were selected randomly.There were 17 male and 6 female ,with the mean age of 60.2 years.Examination was performedfor 8 patients at 1 month after surgery,and 5 patients at 3months , 6 months and 12 months after surgery ,respectively . Five healthy volunteers were selected ascontrol ,including 3 male and 2 female,with the mean age of61.2 years.All patients underwent following examinations.⑴Radiopaque markers examination:the radiopaque markers(Xianshizi,XSZ)were intook,and then the numbers of XSZexpelled from stomach were calculated under x-ray at 30minutes,60 minutes,90 minutes,120 minutes and 240minutes . ⑵Detection of blood motilin and gastrin byradio-immunity assay . ⑶Esophageal manometry forobservation of resting pressure and peristaltic contraction of theremnant esophagus,intrathoracic stomach and anastomoticorifice.And also we analyzed the correlation between gastricemptying and gastrointestinal hormone.Results:1 Thirty minutes after intaking the XSZ,therewas no sig-differences in the gastric emptying rates in all thegroups (P>0.05).At 60 minutes,90 minutes and 120minutes,the gastric emptying rates were lower than that of thecontrol group(P<0.05),but had no difference between them(P>0.05).At 120 minutes,there was no statisticaldifferences in gastric emptying rates between patients andcontrols(P=0.222).2 The blood concentration of motilin and gastrin in thecontrol group was obviously lower than that in the preoperativeand postoperative groups(P<0.05),but there was no differencebetween the preoperative and postoperative groups(P>0.05).3 The differences of resting pressure were not measuredbetween intrathoracic stomach and the remnant esophagus(P>0.05),and there was no high pressure zone at theanastomotie orifice.The primary peristaltic number of thecontrol group was more than that of the postoperative groups(P<0.05).There was no difference in primary esophagealperistasis at 1,3 and 6 months after surgeries(P>0.05),butit was higher at 12 months ( P<0.05 ). The esophagealcontracting pressure had the same trend.4 At 120 minutes,the gastric emptying rate of theintrathoracic stomach had the negative correlation with theblood concentration of gastrin(b=-0.543,P=0.003)and motilin(b=-0.472,P=0.011).The primary peristaltic number and thecontracting pressure of remnant esophagus also had thenegative correlation with them,and the statistical data was(r=-0.499,P=0.007),(b=-0.481,P=0.01),(b=-0.556,P=0.002)and(r=-0.591,P=0.001)respectively.Conclusions : 1 The emptying of the intrathoracicstomach was delayed after esophagectomy for cancer,and itcould not improve gradually.2 The blood concentration of motilin and gastrin in thepreoperative and postoperative groups was obviously higherthan that in the control group,and they had the negativecorrelation with the gastric emptying rate of the intrathoracicstomach.This implied that postoperative blood gut hormonemight have compensative regulation on gastric remnantmovement.3 The primary peristaltic number and contracting...
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