Pyloroplasty improves long-term gastric emptying in rats undergoing fundoplication

Background: Conflicting reports exist regarding the permanence of improved gastric emptying (GE) after fundoplication for gastroesophageal reflux in c hildren. Methods: Changes in gastric volume (GV) and GE of a radiolabeled mixed meal induced by a Nissen fundoplication (NF) were compared with those with a NF plus pyloroplasty (NF + P). GE was measured preoperatively, 15 and 30 days postoperation, in 24 Sprague-Dawley rats; 12 had NF alone, and 12 had NF P. Results were expressed as percent gastric retention at 90 minutes (GR(9 0)). GV was measured at the same time periods in 20 additional rats. Results: NF rats had enhanced GE with reduction of preoperative GR(90) from 37.6% to 23.7% at 15 days (P < .05); however, at 30 days the GR90 increase d to 34.3%. NF + P rats had enhanced GE with reduction in GR(90) from 37.2% to 20.8% at 15 days (P < .05), which persisted at 30 days (20.4%), Mean GV decreased from (1.36 mL/100 g body weight) preoperation to 0.86 at 15 days (P < .05) at 15 days in the NF group, and returned to 1.29 at 30 days. Mea n GV decreased from 1.36 to 0.91 at 15 days in the NF + P rats and persiste d at 0.90 at 30 days. Conclusion: In the rat model, NF enhances GE transiently, whereas NF + P pr oduces long-term enhancement of GE. Copyright (C) 2000 by W.B. Saunders Com pany.