Transcutaneous electrogastrography: A non-invasive method to evaluate post-operative gastric disorders?

BACKGROUND/AIMS: With. the development of high-performance computer program s, transcutaneous electrogastrography has experienced a renaissance in the last few years and is widely recommended as a non invasive diagnostic tool to evaluate functional gastric disorders. We assessed the clinical value of electrogastrography in symptomatic and asymptomatic patients after a varie ty of procedures of the upper gastrointestinal (GI) tract. METHODOLOGY: Electrogastrography tracings were recorded with a commercially available data logger using a recording frequency of 4 Hz. A standard meal was given between a 60min preprandial and a 60min postprandial period. The following parameters were analyzed pre- and postprandially utilizing Fouri er and spectral analysis: Regular gastric activity (2-4 cycles/minute), bra dygastria (0.5-2 cycles/minute), tachygastria (4-9 cycles/minute), dominant frequency and power of the dominant frequency. Nineteen asymptomatic healt hy volunteers served as a control group. Forty-nine patients, who had under gone upper intestinal surgery, were included in the study (cholecystectomy n=10, Nissen fundoplication n=10, subtotal gastrectomy n=8, truncal vagotom y, and gastric pull-up as esophageal replacement n=6). Twenty of these pati ents complained of epigastric symptoms postoperatively, while 12 of these 2 0 patients also h-ad a scintigraphic gastric emptying study with Tc99(m) la beled semisolid meal. RESULTS: Preprandial gastric electric activity was between 2 and 4 cycles/m inute in 60-90% of the study time in healthy volunteers. In all study group s the prevalence and power of normal electric activity increased significan tly after the test meal (p<0.001). After cholecystectomy, Nissen fundoplica tion, subtotal gastrectomy or vagotomy and gastric pull-up pre- and postpra ndial gastric electric activity showed a greater variability compared to no rmal volunteers (p<0.05), but no typical electrogastrography pattern could be identified for the different surgical procedures. There was no significa nt difference in the electrogastrography pattern between asymptomatic and s ymptomatic patients and patients with normal or abnormal scintigraphic gast ric emptying curves. CONCLUSIONS: There is no specific electrogastrography pattern to differenti ate between typical surgical procedures or epigastric symptoms. To-date, el ectrogastrography does not contribute to the diagnosis and analysis of gast ric motility disorders after upper intestinal surgery.