Preliminary report of electrogastrography in pediatric gastroresection: Can it be predictive of alteration of gastric motility?

Background/Purpose: Gastric resection is an infrequent surgical procedure i n childhood. However, the use of the stomach for bladder augmentation and s ubstitution is well documented. Partial gastrectomy performed in gastrocyst oplasty (GCP) involves the greater curvature of the stomach, the same area in which gastric pace-maker cells are known to be placed. The aim of this s tudy was to assess, by electrogastrography (EGG), if subtotal gastric resec tion can alter gastric motility in children submitted to partial gastrectom y for GCP. Methods: Gastric electrical activity (GEA) was evaluated in 25 children usi ng EGG: 10 patients (4 boys, 6 girls; mean age, 11.6 years) previously subm itted to GCP, and 15 normal subjects (12 boys, 3 girls; mean age, 8.62 +/-2 .77 years) as controls. All patients were submitted to cutaneous EGG; recor ding GEA for 30 minutes before and after a standard test meal. The percenta ge of 3 cycles per minute (3CPM), bradygastria, tachygastria, DFIC (dominan t frequency instability coefficient), DPIC (dominant power instability coef ficient), PDP (period dominant power), PDF (period dominant frequency) were recorded and analyzed using Wilcoxon matched-pair test. Data were consider ed statistically significant if P <.05. Results: Normal subjects as well as operated patients showed a statisticall y significant difference in bradygastria (P =.05), PDP and PDF (P =.05) per centage, comparing pre versus postprandial period. In the normal group, 3CP M (P =.0012) and DFIC (P =.0008) were statistically different between the p re- and postprandial period. Patients who underwent GCP did not show any st atistically significant difference in 3CPM and DFIC pre- and postprandial. Conclusions: In normal subjects, GEA showed a complete variation after the meal, whereas in operated patients GEA was impaired and only partially modi fied after the meal. This observation suggests that in patients with gastri c resection, adaptation of the stomach to food ingestion is present but inc omplete with respect to normal subjects; it can be caused by surgical remov al of the pace-maker cells of the greater-curvature. For this reason a foll ow-up analysis of gastric function is recommended for all patients undergoi ng GCP. J Pediatr Surg 36:1157-1159. Copyright (C) 2001 by W.B. Saunders Co mpany.