A flow visualization model of duodenogastric reflux after esophagectomy with gastric interposition

详细信息    查看全文

• 作者：Chul-Hyun Park (5)
  Jae-Ik Lee (5)
  Jaeyong Sung (6)
  Sunghoon Choi (6)
  Kwang-Pil Ko (7)
  
• 关键词：Esophageal surgery ; In vitro studies ; Quality of life
• 刊名：Journal of Cardiothoracic Surgery
• 出版年：2013
• 出版时间：December 2013
• 年：2013
• 卷：8
• 期：1
• 全文大小：531 KB
• 参考文献：1. Dresner SM, Griffin SM, Wayman J, Bennett MK, Hayes N, Raimes SA: Human model of duodenogastro-oesophageal reflux in the development of Barrett’s metaplasia. / Br J Surg 2003, 90:1120-128. CrossRef
  2. Chattopadhyay TK, Shad SK, Kumar A: Intragastric bile acid and symptoms in patients with an intrathoracic stomach after oesophagectomy. / Br J Surg 1993, 80:371-73. CrossRef
  3. Yamashita Y, Hirai T, Saeki S, Yoshimoto A, Noma K, Toge T: Comparison of duodenogastric reflux (DGR) to esophageal substitute between retrosternal route and posterior mediastinal route. / Nihon Kyobu Geka Gakkai Zasshi 1994, 42:1897-903.
  4. Gutschow CA, Collard JM, Romagnoli R, Michel JM, Salizzoni M, H?lscher AH: Bile exposure of the denervated stomach as an esophageal substitute. / Ann Thorac Surg 2001, 71:1786-791. CrossRef
  5. Aly A, Jamieson GG: Reflux after oesophagectomy. / Br J Surg 2004, 91:137-41. CrossRef
  6. Shih WJ, Coupal JJ, Domstad PA, Ram MD, Deland FH: Disorders of gallbladder function related to duodenogastric reflux in technetium-99m DISIDA hepatobiliary scintigraphy. / Clin Nucl Med 1987, 12:857-60. CrossRef
  7. Palmes D, Weilinghoff M, Colombo-Benkmann M, Senninger N, Bruewer M: Effect of pyloric drainage procedures on gastric passage and bile reflux after esophagectomy with gastric conduit reconstruction. / Langenbecks Arch Surg 2007, 392:135-41. CrossRef
  8. Katsoulis IE, Robotis I, Kouraklis G, Yannopoulos P: Duodenogastric reflux after esophagectomy and gastric pull-up: the effect of the route of reconstruction. / World J Surg 2005, 29:174-81. CrossRef
  9. Gawad KA, Hosch SB, Bumann D, Lübeck M, Moneke LC, Bloechle C, Knoefel WT, Busch C, Küchler T, Izbicki JR: How important is the route of reconstruction after esophagectomy: prospective randomized study. / Am J Gastroenterol 1999, 94:1490-496. CrossRef
  10. Wang LS, Huang MH, Huang BS, Chien KY: Gastric substitution for resectable carcinoma of the esophagus: an analysis of 368 cases. / Ann Thorac Surg 1992, 53:289-94. CrossRef
  11. Donington JS: Functional conduit disorders after esophagectomy. / Thorac Surg Clin 2006, 16:53-2. CrossRef
  12. Yajima K, Kosugi S, Kanda T, Matsuki A, Hatakeyama K: Risk factors of reflux esophagitis in the cervical remnant following esophagectomy with gastric tube reconstruction. / World J Surg 2009, 33:284-89. CrossRef
  13. Lee JI, Choi S, Sung J: A flow visualization model of gastric emptying in the intrathoracic stomach after esophagectomy. / Ann Thorac Surg 2011, 91:1039-045. CrossRef
  14. Lirón R, Parrilla P, Martinez de Haro LF, Ortiz A, Robles R, Luján JA, Fuente T, Andrés B: Quantification of duodenogastric reflux in Barrett’s esophagus. / Am J Gastroenterol 1997, 92:32-6.
  15. Singh S, Bradley L, Richter J: Determinants of esophageal alkaline pH environment in controls and patients with gastro-esophageal reflux disease. / Gut 1993, 34:309-16. CrossRef
  16. Soffer EE, Thongsawat S, Ellerbroek S: Prolonged ambulatory duodeno-jejunal manometry in humans: normal values and gender effect. / Am J Gastroenterol 1998, 93:1318-323. CrossRef
  17. Bemelman WA, Verburg J, Brummelkamp WH, Klopper PJ: A physical model of the intrathoracic stomach. / Am J Physiol 1988, 254:G168-G175.
  18. White FM: Viscous flow in ducts. In / Fluid mechanics. Edited by: White FM. New York: McGraw-Hill; 1988:302-65.
  
• 作者单位：Chul-Hyun Park (5)
  Jae-Ik Lee (5)
  Jaeyong Sung (6)
  Sunghoon Choi (6)
  Kwang-Pil Ko (7)
  
  5. Department of Thoracic & Cardiovascular Surgery, Gachon University Gil Hospital, Incheon, Korea
  6. Department of Mechanical Engineering, Seoul National University of Science and Technology, Seoul, Korea
  7. Department of Preventive Medicine, Gachon University of Medicine and Science, Incheon, Korea
  
• ISSN：1749-8090

文摘

Background Our goal was to verify surgical factors that affect duodenogastric reflux (DGR) after esophagectomy through the use of a flow visualization model that would mimic an intrathoracic gastric tube. Methods Transparent gastric tube models for different routes (retrosternal space [RS] and posterior mediastinum [PM]) were fabricated. Various distal pressures were applied to the experimental model filled with water, and the flow was recorded with a high-speed camera. The volume and maximum height of the refluxate through the pylori of two different sizes (7.5?mm, 15?mm) in two different postures (upright, semi-Fowler) was measured by analyzing the video clips. Results For the large pylorus setting, when the pressures of 20, 30, and 40?mmHg were applied in the upright position, the volumes of the refluxate in the RS/PM tubes were 87.7?±-.1/96.4?±-.7?mL, 150.8?±-.1/158.0?±-.2?mL, and 156.8?±-.3/198.0?±-.7?mL (p-lt;-.05), and the maximum heights were 101.6?±-.8/113.4?±-.9?mm, 151.4?±-.2/165.4?±-.5?mm, and 166.1?±-.7/193.7?±-.6?mm (p-lt;-.05). The data for the small pylorus setting or in the semi-Fowler position showed similar tendencies. For any given route, posture or pressure setting, DGR in the large pylorus model was definitively higher than that for small one. Conclusions This fluid mechanics study demonstrates posterior mediastinal gastric interposition or pyloric drainage procedure, or both, is associated with high reflux of duodenal contents.