Evaluation of electrical activity after vagus nerve-preserving distal gastrectomy using multichannel electrogastrography

Abstract

BackgroundMultichannel electrogastrography (M-EGG) can be used to evaluate gastrointestinal motility. The myoelectric activity of the remnant stomach after surgery has not been measured by M-EGG. This study examined whether myoelectric activity varied with surgical technique and compared vagus nerve-preserving distal gastrectomy (VP-DG) with standard distal gastrectomy without vagus nerve preservation (DG). Furthermore, we examined the relationship between the M-EGG findings and patients' postoperative symptoms.MethodsTwenty-six patients who underwent VP-DG, 20 who underwent DG, and 12 healthy volunteers as controls were examined with M-EGG. The Gastrointestinal Symptom Rating Scale (GSRS) was used to assess postoperative symptoms.ResultsLonger periods of normal gastric function (normogastria, 2.0–4.0 cycle min–1) were detected in channel 1 in the VP-DG group than in the DG group in either the fasted or fed state (P<0.05). The percentage of slow wave coupling (%SWC) in the fed state correlated negatively with GSRS scores (reflux, r=–0.59, P=0.02; abdominal pain, r=–0.51, P=0.04, indigestion, r=–0.59, P=0.02 and total score, r=–0.75, P=0.02).ConclusionsSlow waves can be recorded non-invasively using M-EGG in the remnant stomach following gastrectomy. The VP-DG group showed better preserved gastric myoelectric activity than the DG group, and the %SWC showed a significant negative correlation with scores of GSRS (reflux, abdominal pain, indigestion and total score) in the VP-DG group.

Current status of multichannel electrogastrography and examples of its use

“…Thus, slow waves can be recorded non-invasively by M-EGG in the remnant stomach following gastrectomy. The VP-DG group showed better preservation of gastric myoelectric activity than the DG group (67). …”

“…M-EGG was performed in 20 patients who had undergone distal gastrectomy without vagus preservation (DG group), in 26 patients who had undergone distal gastrectomy with preservation of the fundic branches of the vagus nerve (VP-DG group) and in 12 healthy volunteers (67). M-EGG was performed 2 weeks after surgery.…”

A Randomized Controlled Trial of Vagus Nerve-preserving Distal Gastrectomy Versus Conventional Distal Gastrectomy for Postoperative Quality of Life in Early Stage Gastric Cancer Patients

“…1). 18 Preservation of gastric motility due to with remnant fundic branches may be associated with better digestive function and may prevent appetite loss in VPG.…”

“…Furthermore, these studies had limited sample size. 8,15,17,18 As a consequence, we conducted a randomized controlled trial to compare the postoperative QoL among early-stage gastric cancer patients with VPG vs CG.…”

Relationships between Length of the Antral Cuff and Postgastrectomy Disorders and Gastric Empting Function in Patients after Pylorus-Preserving Gastrectomy for Early Gastric Cancer

“…In clinicopathological analyses, PPG are associated with clearly lower incidences of early dumping syndrome (EDS), gastritis in the remnant stomach and reflux esophagitis (RE) as well as a significant decrease in postoperative malnutrition due to loss of appetite and postoperative body weight loss [1] [7]. Frequencies of PAF after PPG have been reported at 30% to 60% [1] [2] [3] [5] [6] [7] [8].…”