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Ann Thorac Surg 1991;51:759-763
© 1991 The Society of Thoracic Surgeons

Articles

Gastric emptying after gastric interposition for cancer of the esophagus or hypopharynx

Kathryn A. Morton, MD*,a,b, Shreekant V. Karwande, MDa,b, R. Kim Davis, MDa,b, Frederick L. Datz, MDa,b, Robert E. Lynch, MDa,b

a Nuclear Medicine Service, Department of Surgery/Otolaryngology, and Research and Laboratory Services, Veterans Affairs Medical Center, Salt Lake City, Utah USA
b Departments of Radiology, Surgery, and Pathology, University of Utah Medical School, Salt Lake City, Utah USA

Accepted for publication December 31, 1990.

* Address reprint requests to Dr Morton, Nuclear Medicine Service (115), VA Medical Center, 500 Foothill Blvd, Salt Lake City, UT 84148.

Transhiatal esophagectomy with primary anastomosis to the stomach (gastric pull-up) is an attractive surgical alternative to colic interposition in patients with cancer of the esophagus and hypopharynx. However, the lack of intrinsic gastric peristalsis and complaints by patients ol postprandial regurgitation prompted us to measure the effect of body posture on the rates of gastric emptying in these patients. The rates of solid and liquid gastric emptying were measured in 14 patients who had undergone gastric interposition for esophageal and hypopharyngeal carcinoma. Rates of emptying were measured in both the supine and upright position using a dualisotope radiolabeling technique. In these patients, the rate of gastric emptying of both solids and liquids was significantly slower in the supine position than in the upright position. Emptying in supine patients was also prolonged when compared with supine normal volunteers. Conversely, the upright rate of solid and liquid emptying in the patients was accelerated when compared with published values for upright normal volunteers. We conclude that gastric emptying after gastric interposition is dependent on upright posture after meals.




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