Reduction of lower esophageal sphincter pressure with stamm gastrostomy

Effects of Stamm Gastrostomy on Gastric Emptying Rate in Rats

“…In accordance with these results, Langer et al [18] have also established the occurrence of reflux (43%) postoperatively. An experimental study in cats also demonstrated that SG might predispose to the development of GER [5]. In our study, GER was observed in 5/7 of rats, while no evidence of esophageal inflammation was present in either sham or control group.…”

“…These results suggest that GER is not accompanied by delayed gastric emptying in this experimental model. Several clinical and experimental studies have reported that PEG [11][12][13] and Stamm [4,5,[14][15][16] gastrostomies done in children with a negative preoperative evaluation of GER, have a relatively low incidence of postoperative GER. In contrary, a high incidence of GER after PEG or SG was documented in many clinical and experimental studies.…”

“…Since majority of the pediatric patients with neurological disorders are concerned and one cannot differentiate between neurological and surgical alterations of the lower esophageal sphincter, it is critical to clarify the mechanisms of the GER development following gastrostomies. Canal et al [5] documented that gastrostomy tube placement in cats resulted in a significant reduction in the lower esophageal sphincter (LES) pressure in the immediate postoperative period and at 1 and 2 weeks after operation. Another study by Papaila [6] indicated that gastrostomy associated with fixation of the stomach to the anterior abdominal wall resulted in a decrease in lower esophageal high-pressure zone in cats.…”

“…Eur Surg Res 2004;36:362-366 363 lated as the causative factors for GER [4][5][6]. However, potentially important pathophysiological role of gastric emptying has not been thoroughly evaluated yet.…”

Swallowing Disorders in the Older Population

“…Therefore, misdirection of contaminated oral secretions, the most common contributor to aspiration pneumonia, is not reduced or eliminated by the placement of a feeding tube of any kind . Further, in animal studies, it has been demonstrated that reflux of gastric contents is increased due to a reduction in the pressure of the lower esophageal sphincter with a gastrostomy tube in place . Thus, it is not surprising that ample evidence fails to demonstrate a reduction of aspiration of gastric contents or the occurrence of aspiration pneumonia from misdirected oral secretions after feeding tubes are placed .…”