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Differential gastric emptiness according to preoperative stomach position in neurological impaired patients who underwent laparoscopic fundoplication and gastrostomy

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Abstract

Purpose

We sometimes experienced prolonged delayed gastric emptying (DGE) in neurologically impaired patients undergoing laparoscopic fundoplication and gastrostomy. We explored the difference in the DGE rate according to the preoperative stomach position.

Methods

Thirty-two neurological impaired patients who underwent laparoscopic fundoplication and gastrostomy between 2015 and 2019 were classified into two groups based on stomach position: non-elevated stomach position (NESP) and elevated stomach position (ESP). Patients’ characteristics, operative result and postoperative gastric emptying were reviewed.

Results

The 11 ESP patients were significantly older than the 21 NESP patients (p < 0.05). The ESP patients had a significantly heavier body weight (BW) than the NESP patients (p < 0.05). The time taken (days) to reduce gastric drainage (days, below BW × 10 ml) in the NESP (4.3 ± 3.6) was significantly longer than that of ESP (1.3 ± 1.6) (p < 0.05). The time taken (days) to achieve full enteral nutrition in the NESP (14.1 ± 8.9) was significantly longer than that of the ESP patients (8.8 ± 3.1) (p < 0.05).

Conclusion

Elevated stomach position (ESP) patients archived full enteral nutrition earlier than NESP patients after laparoscopic fundoplication and gastrostomy. Stomach position correction might, therefore, be involved in the incidence of DGE.

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Acknowledgements

We thank Mr. Brain Quinn for his comments and help with the manuscript. This study was supported by Grants-in-Aid for Scientific Research from the Japan Society for the Promotion of Science (JSPS, nos. 16K11350, 19K09150), research grant from JFE (The Japanese Foundation for Research and Promotion of Endoscopy), research grant from J-CASE (Japanese Consortium of Advanced Surgical Endoscopy), research grant from Kyushu Society of Endoscopic and Robotic Surgery, research grant of Karl Storz Award from Japan Society for Endoscopic Surgery, research grant from The Mother and Child Health Foundation, research grant from the Kawano Masanori Memorial Public Interest Incorporated Foundation for Promotion of Pediatrics, and Research Grant from Princess Takamatsu Cancer Research Fund.

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No funding was received for this article.

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Authors and Affiliations

  1. Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 890-8520, Japan

    Makoto Matsukubo, Tatsuru Kaji, Shun Onishi, Toshio Harumatsu, Ayaka Nagano, Mayu Matsui, Masakazu Murakami, Koshiro Sugita, Keisuke Yano, Koji Yamada, Waka Yamada, Mitsuru Muto & Satoshi Ieiri

  2. Clinical Training Center, Kagoshima University Hospital, Kagoshima, Japan

    Tatsuru Kaji & Waka Yamada

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  1. Makoto Matsukubo
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  2. Tatsuru Kaji
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  12. Mitsuru Muto
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  13. Satoshi Ieiri
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Correspondence to Satoshi Ieiri.

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Matsukubo, M., Kaji, T., Onishi, S. et al. Differential gastric emptiness according to preoperative stomach position in neurological impaired patients who underwent laparoscopic fundoplication and gastrostomy. Surg Today 51, 1918–1923 (2021). https://doi.org/10.1007/s00595-021-02274-w

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  • DOI: https://doi.org/10.1007/s00595-021-02274-w

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