| Objective: After esophagectomy for cancer, many patients had the symptom of anorexia, abdominal distention, belching, reflux, diarrhoea and nausea because of the destruction of anatomic structure and the alteration of neural and humoral regulation of the upper gastrointastinal tract. It has been reported that these pathophysiological changes of alimentary tract caused these symptoms. In this study, we observed the gastric emptying by radiopaque markers and compare the effect of stomach and intestines kinetic drug on intrathoracic stomach.Materials and Methods: Forty-six patients who had underwent esophagectomy for esophageal carcinoma at the Department of Thoracic Surgery, Fourth Hospital, Hebei Medical University between January 2007 and January 2009 were selected randomly. They were divided into two groups randomly: group A (n=23) were given 3 times of 5 mg mosapride for 2 weeks and group B (n=23) were given no tablets. There were 32 male and 14 female, with the mean age of 60.2 years. Radiopaque markers examination was conducted in 16 patients at 1 month after surgery, and 10 patients at 3 months, 6 months and 12 months after surgery, respectively. Five healthy volunteers were selected as normal controls, including 3 male and 2 female, with the mean age of 61.2 years. All patients underwent radiopaque markers examination. After the radiopaque markers (Xianshizi, XSZ) were intaken , the numbers of XSZ expelled from stomach were calculated under fluoroscope at 30 minutes, 60 minutes, 90 minutes and 120 minutes.Resaults: 1. At 60 minutes, 90minutes and 120 minutes, the intrathoracic gastric emptying rates in patients who had underwent esophagectomy for cancer were lower than that of the control group (p<0.05).2. One month after surgery, there was no significant differences in the all groups (p>0.05) in the gastric emptying of XSZ at 30 minutes and 60 minutes. At 90 minutes and 120 minutes, the gastric emptying rates in Group A were higher than that of Group B (p<0.05), but lower than that of normal controls (p<0.01).3. Three months after surgery, there was no significant differences in all the groups (p>0.05) in the gastric emptying at 30 minutes. There was no statistical differences in gastric emptying rates at 60 minutes between group A and B. At 90 minutes and 120 minutes, the gastric emptying rates in Group A were higher than that of Group B (p<0.05), but lower than that in normal control group (p<0.05).4. Six months after surgery, there was no significant differences in all the groups in gastric emptying of XSZ at 30 minutes (p>0.05). At 60 minutes, 90 minutes and 120 minutes, the gastric emptying rates in Group A were higher than that of Group B (p<0.01), but there was no significant differences between Group A and normal controls (p>0.05).5. Twelve months after surgery, there was no significant differences in all the groups (p>0.05) in gastric emptying of XSZ at 30 minutes. At 60 minutes, 90 minutes and 120 minutes, the gastric emptying rates of Group A were higher than that of Group B (p<0.05), but there was no significant differences between Group A and normal controls (p>0.05).Conclusions: 1. The emptying of the intrathoracic stomach was delayed after esophagectomy for cancer.2. Mosapride improves the intrathoracic gastric emptying after esophagectomy for cancer.3. The effect of mosapride on the improvement of intrathoracic gastric emptying increase over time. |
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