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

第一部分：同时测量胃张力和上消化道压力活动。本研究旨在描述空腹和餐后状态下近端胃的动力模式，并阐明健康受试者近端和远端胃在固体餐排空中的相对作用。使用电子恒压器和测压系统，同时测量胃张力和上消化道压力活动。胃张力的消化间期变化与上消化道的消化间期运动周期相协调，禁食期间近端胃中一半以上的阶段性收缩与胃窦收缩相关。这项研究还表明，近端胃的阶段性收缩与固体排空阶段期间的胃窦收缩相关，这强烈支持近端胃启动胃窦泵的概念，逐渐将固体物质向下压入胃窦。食管切除术后间置结肠段的运动功能为了评价间置结肠段的运动功能，对8例食管癌切除结肠代癌患者进行了研究。通过Micro Digitrapper（Synectics Medical）进行24小时动态研究。在白天，结肠段的运动活动的特点是突然增加的运动与食物的摄入。进食与运动模式的迅速变化相关，产生连续的阶段性收缩。结肠收缩（PC）沿整个结肠段沿着迁移，常发生在餐后和晨醒后。在24小时动态研究中，插入结肠的运动性显示餐后活动显著增加。这项研究表明，结肠段实际上是食管的替代品。

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.