Problems in Oral Intake after Esophageal Reconstruction with Gastric Tube and its Managements

Tatsuyuki Kawano, Kunihide Yoshino, Kagami Nagai, Haruhiro Inoue, Takeshi Nagahama, Satoshi Miyake, Yosuke Izumi, Masanori Nakamura, Satoshi Nara, Metasate Assada, Hikaru Hori, Mitsuo Endo

First Department of Surgery, Tokyo Medical and Dental University School of Medicine

The problems of oral intake that occur after esophagectomy and its reconstruction for esophageal cancer and the clinical examinations for evaluation of them were discussed. Out of 483 patients who had esophagectomy and reconstruction in our department in the recent 10 years, we evaluated the data from a qestionnaire about oral intake of 134 patiens who were doing well without cancer recurrence and in whom the esophagus was reconstruted with the gastric tube. The patients were consisted with 119 men and 15 women, the mean postoperative period was 42 months, and the reconstruction routes were categorized as three types, retrosternal in 95 cases, posterior mediastinal in 9, and other resonstructive methods in 10 . Although 128 patients (96%) complained of some discomforts about the oral intake such as the limitation of the amount of food, 62 patients (46%) had continuous complaints, and the main symptoms were caused by the decrease in the stomach volume as a reservoir and the so-called dumping syndrome. The evaluation of these symptoms was not easy. Some symptoms caused by esophageal resection and reconstruction may be unavoidable. However, some methods of evaluation of the esophagogastric motility function were useful for understanding the pathophysiology of postoperative disorders. The double marker absorption method in the gastric emptying test and electrogastrography (EGG) are expected as new objective examination methods for gastric tube motility function. According to the results of the examination, modification of the life style and medication such as prokinetics were effective in some patients.

Key words
esophageal reconstruction with a gastric tube, oral intake after esophageal reconstruction, electrogastrography (EGG)

Reprint requests
Tatsuyuki Kawano First Department of Surgery, Tokyo Medical and Dental University School of Medicine
1-5-45 Yushima, Bunkyo-ku, Tokyo, 113 JAPAN

Accepted
June 14, 1995

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