MOTOR ACTIVITY OF THE CERVICAL ESOPHAGUS AND RECONSTRUCTIVE ORGANS AFTER ESOPHAGECTOMY

S Shibuya, S Miyazaki, G Miyata, N Tonotuka, S Satomi

Division of Advanced Surgical Science and Technology, Graduate School of Medicine, Tohoku University, Sendai, Japan

The patients who underwent esophagectomy complain many symptoms at the follow-up periods. Most of these symptoms are stenotic sensation and regurgitation. Although these seems to be related to the motility of residual esophagus and reconstructive organs, functional evaluation had not been evaluated enough in those postoperative situation. Therefore, we investigated the motility of these organs using manometric examination in patients after esophagectomy.
Thirteen patients who underwent esophagectomy for thoracic esophageal cancer were analyzed in this study. Six of these were performed reconstruction using gastric tube, while remaining 7 patients were reconstructed with colon interposition. All patients had reconstruction through the posterior mediastinal route. Hydrauric manometry was used for assessment of motor activity of these organs. The motor activity was assessed under 10 times of water swallowing (5 ml each).
The residual esophagus and the gastric tube did not respond after the water swallowing. Of those 7 cases of interposed colon, 2 cases responded with peristaltic waves on 3 out of 10 water swallowings. These two were examined within 6 months of post operation periods. 5 cases did not respond after the water swallowings, and in one case of these, peristaltic waves were detected without swallowing just before termination of manoteric examination. Four of these 13 patients were performed manometry before esophagectomy and normal motility was observed in their esophagus.
The peristaltic waves were not observed in the residual esophagus and the gastric tube after swallowing. Neither in the interposed colon, peristaltic waves were rarely observed after swallowing. The impairment of motor activity of cervical esophagus and reconstructive organs was supposed to lead part of postoperative complaints.