Evaluation of the postoperative motor disorder in the gastrointestinal tract, using a 24-hour ambulatory manometry and an electronic barostat

第1部分：胃张力和上肠压活动的同时测量。本研究旨在研究空腹和餐后状态下近端胃的运动模式，并阐明健康受试者近端胃和远端胃在固体食物排空中的相对作用。使用电子气压计和压力测量系统，同时测量胃张力和上肠压活动。胃张力的消化间变化与上肠的消化间循环相协调，近端胃超过一半的阶段性收缩与禁食期间的胃窦收缩有关。本研究还表明，在固体排空期，近端胃的阶段性收缩与胃窦收缩有关，这有力地支持了近端胃启动胃窦泵，逐渐将固体物质压入胃窦的概念。第二部分：食管癌术后间置结肠段运动功能。为了评估介入结肠段的运动活性，我们对8例食管切除术和结肠置换术患者进行了研究。microdigitrapper （Synectics Medical）进行了一项24小时的门诊研究。在白天，结肠段运动活动的特点是与食物摄入相关的运动性突然增加。进食与运动模式的迅速改变有关，产生连续的阶段性收缩。扩散性宫缩（propagation contraction, PCs）在餐后和早晨醒来时频繁发生，并沿整个结肠段迁移。在24小时的动态研究中，插入结肠的运动在饭后显示出明显的活动增加。这项研究表明，结肠段实际上是食道的替代品。

Part 1 : Simultaneous measurements of gastric tone and upper gut pressure activity.This study aims to characterize motility patterns in the proximal stomach both in fasting and postprandial state, and to elucidate the relative roles playd by the proximal and distal stomach in the emptying of solid meal in healthy subjects. Using an electronic barostat and a manometric system, simultaneous measurements of gastric tone and upper gut pressure activity were performed. The interdigestive variations in gastric tone are coordinated with the interdigestive motor cycle in the upper gut and, more than half of the phasic contractions in the proximal stomach were associated with the antral contractions during fasting. This study also demonstrated that the phasic contractions of the proximal stomach occurred in association with antral contractions during the solid emptying phase, which strongly supports the concepts that the proximal stomach primes the antral pump, gradually pressing solid materials down into the antrum.Part 2 : Motor function of the interposed colonic segment after esophagectomy.In order to evaluate the motoractivity of the interposed colonic segment, eight patients who had undergonean esophagectomy and colonic replacement were studied. A 24-hour ambulatorystudy was performed by a Micro Digitrapper (Synectics Medical). In the daytime, motor activity of the colonic segment was characterized with a sudden increase in motility in association withfood intake. Ingestion of a meal was associated with a prompt change in motility pattern, producing continuous phasic contractions. Propagated contractions (PCs) which migrated along the entire colonic segment occurred frequently in the postprandial period and aftermorning awakening. The motility of the interposed colon showed a marked increase in activity after a meal in the 24-hour ambulatory studies. This studydemonstarated that the colonic segment actually works as a substitute for the esophagus.