EMPTYING OF THE INTRATHORACIC STOMACH USING 3 DIFFERENT PYLORUS DRAINAGE PROCEDURES - RESULTS OF A COMPARATIVE-STUDY

Patterns of gastric emptying in the vagotomized intrathoracic stomach (used for esophageal replacement) were studied using radioisotope tech niques, Following esophagectomy and gastric mobilization, the patients were randomized into three groups: group 1, pyloroplasty; group 2, py loromyotomy; and group 3, pylorus stretching. A total of 30 patients s urviving the operation and who were still alive at least 3 months afte rwards were included in this study, Gastric emptying (GE) was evaluate d 6-8 weeks after the operation, The mean GE time for liquids was 3.3 +/- 2.7, 4.1 +/- 3.1, and 5.5 +/- 4.3 min in the three groups, respect ively, The corresponding GE time for solids in the three groups was 9. 9 +/- 5.1, 10.31 +/- 6.6, and 7.7 +/- 3.4 min. No statistical differen ce was observed in the GE in the three groups even though liquids tend to empty faster than solids, Clinically there was also no significant difference in their ability to tolerate normal meals. When evaluated for clinical evidence of altered GE (effect of vagotomy) there did not appear to be any significant differences between the three groups, It is therefore concluded that all pylorus drainage procedures behave in much the same way, Patients may develop some problems, but these disa ppear in due course after proper adjustments have been made in both po sture and diet.