| Objective: Gastric emptying delay occurs after esophagectomy for esophageal cancer because of the destruction of anatomic structure and the alteration of neural and humoral regulation of the upper gastrointastinal tract. Long-term occurrence of the symptom of anorexia, abdominal distention, belching, reflux, diarrhoea and nausea has negtive influence on the quality of life of the patients who underwent esophagectomy. This study is conducted to investigate the otherness of gastric emptying time in patients with esophagectomy for esophageal carcinoma in different periodt, and evaluate the effect of erythromycin on intrathoracic gastric emptying and provide evidences for the treatment of gastric emptying delay after esophagectomy.Methods: Thirty patients who had underwent esophagectomy for esophageal carcinoma at the Department of Thoracic Surgery, Fourth Hospital, Hebei Medical University between January 2010 and June 2010 were selected. There were 25 males and 5 females, with the mean age of 59.8 years old. These postoperative patients were divided into two groups randomly: the medication group (11 males, 4 females) were given 3 times of 0.25g erythromycin a day for 1 week and the control group (14 males, 1 female) were given no tablets. Ten healthy volunteers without disease of alimentary tract were selected as normal controls, including 10 males and 5 females, with the mean age of 54.4 years. These subjects in the normal control group and the control group stopped smoking,drinking and taking any medicine influencing the function of stomach and intestines since 1 week ago. They were fasting since 22:00 pm last night. Test meal was prepared from the mixture of sesame seed power(40g), water(200ml), 99Tcm-DTPA(18.5MBq) as a tracer. The patients had the test meal with 99Tcm-DTPA and then tested static imaging at 0 min, 15 min, 30 min, 45 min, 60 min, 75 min, 90 min, 105 min and 120 min, collecting time limited at 1 minute and recording gastric radiation measurement. The two groups had radionuclide gastric emptying test before operation, 1 month, 4 month, 7 month and 10 month after operation. Comparison of gastric half gastric emptying time between control group and medication group before operation and normal control group, comparison of that between control group and medication group at the same postoperative period , comparison of the results at different time points in control group or medication group.Results:1 Comparison gastric emptying time of control group and medication group before operation and the control group.There was no difference of the gastric half gastric emptying time between preoperative control group and normal control group through t-test (t=-0.535 P=0.421 P>0.05). There was no difference of the gastric half gastric emptying time between medication group and normal control group through t-test (t=-1.399 P=0.634 P>0.05).2 The effects and intereffects of time and group.By general linear model to achieve univariate repeated measures analysis of variance data, which showed gastric half gastric emptying time changed with time(F=296.590, P=0.000 ) and the role of the time factor varied with the group (F=37.763, P=0.000) .3 Comparison between control group and medication group at the same postoperative period.The data analyzed by multivariate analysis of variance between two groups showed that 1 month after operation (F=71.527, P=0.000),4 month after operation(F=88.750, P=0.000),7 month after operation (F=78.564, P=0.000) and 10month after operation (F=143.751, P=0.000). There was significantly difference in gastric half gastric emptying time between medication group and control group at the same postoperative time.4 Comparison of the results at different time points in each group. The data about gastric half gastric emptying time, with multiple comparisons paired t-test (Bon-ferroni method), showed that there was no difference in postoperative control group at 1 month and 4 month (P=0.098, P>0.05). The other comparison between each two time points before operation, 1 month, 4 month, 7 month and 10 month after operation showed significant difference (P=0.000, P<0.01) . There was no difference in postoperative medication group at 1 month and 4 month (P=0.119, P>0.05), before operation and 10 month after operation (P=0.885, P>0.05). The other comparison between each two time points of before operation, 1 month, 4 month, 7 month and 10 month after operation showed significant difference (P=0.000, P<0.01) .Conclusions:1 Preoperative patients with esophageal cancer show no delayed gastric emptying, which indicates esophageal cancer itself does not affect gastric emptying.2 Postoperative patients have obvious gastric emptying delay.3 Erythromycin significantly improves intrathoracic gastric emptying in different periods after esophagectomy for cancer.4 There is recovery trend of gastric emptying over time after esophageal cancer surgery. Erythromycin can shorten the time of the recovery. |
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