Gastric emptying after fundoplication is dependent on changes in gastric volume and compliance

Joaquim Bustorff-Silva, Carlos A. Perez, Eric W. Fonkalsrud, Carl Hoh, Helen E Raybould

Research output: Contribution to journalArticle

13 Scopus citations

Abstract

Background/Purpose: Nissen gastroesophageal fundoplication (GEF) increases gastric emptying (GE); however, the duration and the mechanisms for this improvement in GE remain unclear. The aim of this study was to evaluate the effects of a GEF on GE of a mixed meal, and to determine the correlation between GE and changes in intragastric pressure (IGP) and compliance. Methods: Using a radiolabeled mixed meal, GE was measured preoperatively 15 and 30 days after operation in 24 Sprague-Dawley rats divided into SHAM and GEF groups. Results were expressed as percent gastric retention at 90 minutes (GR90), and time to evacuate 50% of the isotope meal (T(1/2)). Changes in IGP and compliance were determined at the same time-points using a different set of 20 rats. Results: Fifteen days after surgery, GR90 and T(1/2) in the GEF group were reduced significantly when compared with preoperative values but returned to near preoperative values 30 days postoperation. In contrast, rats from the SHAM group showed no change in GR90 and T(1/2) at 15 days and 30 days postoperation. Immediately after GEF, maximal distension of the stomach resulted in pressures 65% higher than those recorded before operation (20.2 v 11.7 mm Hg; P < .05), which persisted on the 15th postoperative day (17.7 v 10.7 mm Hg; P<.05). On the 30th postoperative day, however, there was no difference in the IGP between rats undergoing GEF compared with those undergoing a SHAM operation (11.7 v 12.0 mm Hg; P < .05). Similarly, mean gastric compliance decreased significantly immediately after and 15 days after GEF, but returned to preoperative levels 30 days after the operation. Conclusions: In a rat model, GEF produces a transitory increase in GE, which is related to a simultaneous decrease in gastric volume and compliance. However, 30 days after GEF, associated with an elevated IGP, gastric volume increases and GE returns to preoperative levels.

Original languageEnglish (US)
Pages (from-to)1232-1235
Number of pages4
JournalJournal of Pediatric Surgery
Volume34
Issue number8
DOIs
StatePublished - Aug 1999
Externally publishedYes

Keywords

  • Gastric compliance
  • Gastric emptying
  • Gastroesophageal reflux
  • Nissen fundoplication
  • Rats

ASJC Scopus subject areas

  • Surgery

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