Tonic motor activity of the narrow gastric tube used as an oesophageal substitute

Objective: To assess the compliance, the existence of basal tone, the senso ry response to distension, and the integrity of the neurohumoral enterogast ric inhibitory reflex of the narrow gastric tube as an oesophageal substitu te. Design: Explanatory experimental study. Setting: University hospital, The Netherlands. Patients: Eight patients after oesophagectomy, formation of a narrow gastri c tube, and cervical gastro-oesophagostomy. Interventions: Measurements of intragastric tonic motor activity with a Bar ostat. Main outcome measurements: Compliance, sensations during stepwise pressure increments, and changes in tone induced by glucagon and intraduodenal feedi ng. Results: The compliance of the narrow gastric tube was found to be low (med ian 13.5 ml/mmHg (range 5-21)). Most of the patients perceived minimal sens ation on distension. All patients had phasic tonic contractions during dist ension of the gastric tube. The median (range) relaxation after glucagon ha d been given intravenously was 14 ml (range 3-57) (p < 0.05). The tonic rea ction to nutrients in the duodenum was not significant. Conclusions: The compliance of the narrow gastric tube is low. Postprandial symptoms are not caused by distension of the proximal part of the narrow g astric tube. Basal gastric tone and phasic activity were at least partially restored over time after operation. The enterogastric inhibitory reflex is eliminated by oesophageal resection and reconstruction of a gastric tube.