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Journal of Gastrointestinal Surgery

, Volume 18, Issue 5, pp 906–910 | Cite as

Roux-en-Y Limb Motility after Total Gastrectomy

  • Fernando A. M. Herbella
  • Luciana C. Silva
  • Fernando P. P. Vicentine
  • Marco G. Patti
Original Article

Abstract

The Roux-en-Y stasis syndrome is a troublesome postgastrectomy syndrome. Although the era of gastric resection for peptic ulcer disease has almost come to an end, the increasing incidence of proximal gastric cancer and the outbreak of bariatric operations make the study of the motility of the Roux-en-Y limb (RYL) after gastric resection or gastroplasty very relevant.This study aims to evaluate the motility of the RYL after total gastrectomy using high-resolution manometry (HRM). We performed an HRM on 8 patients after total gastrectomy for proximal gastric cancer and Roux-en-Y reconstruction, 74 ± 111 months after the operation. At the time of the study, all patients were asymptomatic without evidence of cancer recurrence.Peristaltic waves were noticed at the RYL in 3 (37 %) of the patients. The mean wave amplitude of the peristaltic waves was 63 ± 29 (37–94) mmHg and 83 ± 35 (42–104) mmHg at 3 and 7 cm below the esophagojejunal junction, respectively. Simultaneous waves were noticed in 6 (75 %) of the patients in 80 ± 32 % (30–100) of the swallows of these patients. No patient presented with absence of motor activity detectable at the HRM. Our results show that: (1) esophageal motility is normal after total gastrectomy with Roux-en-Y reconstruction; (2) motor activity is always detectable at the proximal RYL, but peristalsis is abnormal in most patients; and (3) absence of peristalsis does not translate into symptoms.

Keywords

Total gastrectomy Roux-en-Y esophagojejunostomy Roux-en-Y syndrome Post-gastrectomy syndromes Small bowel manometry High-resolution manometry 

Notes

Acknowledgments

We are indebted to Ms. Mirian Wolfarth and Ms. Priscila M.A. Capuzzo for their invaluable assistance with the tests.

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Copyright information

© The Society for Surgery of the Alimentary Tract 2014

Authors and Affiliations

  • Fernando A. M. Herbella
    • 1
    • 3
  • Luciana C. Silva
    • 1
  • Fernando P. P. Vicentine
    • 1
  • Marco G. Patti
    • 2
  1. 1.Department of Surgery, Escola Paulista de MedicinaFederal University of Sao PauloSao PauloBrazil
  2. 2.Department of SurgeryUniversity of ChicagoChicagoUSA
  3. 3.Surgical Gastroenterology, Division of Esophagus and StomachHospital Sao PauloSao PauloBrazil

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