The effects of Roux-en-Y limb length on gastric emptying and enterogastric reflux in rats

Abstract

PURPOSE: To assess the effects of Roux-en-Y jejunal limb length on gastric emptying and enterogastric reflux. METHODS: Seventy male Wistar rats were submitted to antrectomy with Roux-en-Y reconstruction and then were divided into two groups of 35 animals. Group A, short limb (7.5 cm) and Group B, standard limb (15 cm). Group A and B were subdivided into five subgroups each in order to study enterogastric reflux at 30 and 60 minutes and to evaluate gastric emptying at 5, 10 and 15 minutes. In order to measure gastric emptying and enterogastric reflux, radiotracers 99m Tc-Phytate and 99m Tc-DISIDA were respectively used. RESULTS: For gastric emptying, the radiotracer concentration was lower in Group A than in Group B after five minutes. The enterogastric reflux was present, but there were no significant differences between enterogastric reflux indexes concerning both A and B Groups. CONCLUSION: A standard Roux limb, besides being unable to protect the stomach from the enterogastric reflux, may become a functional barrier for gastric emptying.

In vitro motility changes in Roux limb after Roux-en-Y reconstructio

“…These contractions were also increased signifi cantly in vagotomized Roux-en-Y group (Group B) compared to non-vagotomized Roux-en-Y group (Group A) (p < 0.05). The values of pD 2 were similar in all three groups (Figs 2 and 3, Tab. 1).…”

“…Hinder et al (19) have reported that the reason for the Roux stasis syndrome lied in the gastric remnant, while extensive gastric resection is an effective means to reduce symptoms and improve gastric emptying in selected patients with severe gastric stasis of solid food after the Roux-en-Y procedure. As opposed to latter authors, Dutre et al (2) showed that besides being unable to protect the stomach from the enterogastric refl ux, the standard Roux limb may become a functional barrier for gastric emptying. These results suggested that jejunal transection may be an important factor for Roux en Y syndrome.…”

“…After gastric resections, the reconstruction of the gastrointestinal transit in Roux-en-Y should prevent the back fl ow of the biliary, enteric and pancreatic secretions to the gastric stump. However, some complications may occur during the late postoperative period, as for example, 30 % of the subjects may develop jejunal ulcers near the gastroenteric anastomosis, and mainly, a delayed gastric emptying (2) Mathias et al (3), described the Roux Stasis Syndrome which is characterized by abdominal pain, nausea, and vomiting worsened after food ingestion. These symptoms may occur due to motor impairment in the Roux-en-Y limb leading to a delayed gastric emptying.…”

Roux-en-Y gastroenteroanastomosis in the treatment of stenosing and advanced gastric adenocarcinoma

“…In Brazil, official records show that cancer rates highest average annual age-adjusted incidence per 100 000 men were found in São Paulo -SP (1997-1998: 38.8), Federal District -DF (1996 to 1998: 32, 7) and Belém -PA (1996-1998: 27.6). In the female population, the highest rates were observed in São Paulo (1997-1998: 15 3,4 . The adenocarcinoma is the most commom histopatologic type.…”

“…The geographical distribution of stomach cancer is characterized by its wide international variation. The country with the highest incidence is Japan (77.9 per 100.000 in men and 33.3 per 100.000 in women), but high rates are also observed in Central America, South America and East Asia.In China, it is the highest incidence (43.7 per 100,000 in men and 18.9 per 100,000 in women) 1,2,3 . In Brazil, official records show that cancer rates highest average annual age-adjusted incidence per 100 000 men were found in São Paulo -SP (1997-1998: 38.8), Federal District -DF (1996 to 1998: 32, 7) and Belém -PA (1996-1998: 27.6).…”