Trans-cutaneous electrogastrographic study of gastric myoelectric activity in transposed intrathoracic stomach after esophagectomy

Wong, Simon; Chiu, Philip Wai Yan; Wu, Justin C.Y.; Sung, Joseph J.Y.; Ng, Enders Kwok Wai

doi:10.1111/j.1442-2050.2007.00641.x

Cited by 3 publications

(6 citation statements)

References 15 publications

(18 reference statements)

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“…Gastric surgery modifies the electrical conduction system that coordinates contractions (15), with previous studies implicating abnormal electrophysiology in conduit dysfunction (3-5). However, reliable techniques to assess conduit function have been lacking.…”

Section: Discussionmentioning

confidence: 94%

“…Recent advances have enabled substantial progress in evaluating gastric electrophysiology in health and disease (7, 16, 17). A legacy technique termed electrogastrography (EGG) previously attempted to capture gastric electrical activity from the skin surface, but was limited by low resolution and high sensitivity to noise (5). Gastric Alimetry overcomes these problems by employing an HR array together with sophisticated signal processing algorithms (9, 10), that were shown effective even with conduits positioned in the thorax and posterior mediastinum.…”

Section: Discussionmentioning

confidence: 99%

“…No adverse reactions occurred. Gastric surgery modifies the electrical conduction system that coordinates contractions (15), with previous studies implicating abnormal electrophysiology in conduit dysfunction (3)(4)(5).…”

Section: (Which Was Not Certified By Peer Review)mentioning

confidence: 94%

“…Post-oesophagectomy conduit dysfunction is common, including delayed gastric conduit emptying (DGCE) (~30%) , gastro-oesophageal reflux (~80%), and other chronic symptoms without a mechanical cause (1,2). Emerging evidence implicates abnormal gastric electrophysiology as a contributing factor (3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

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Non-invasive thoracoabdominal mapping of post-oesophagectomy conduit function

Wang

Tokhi

Gharibans

et al. 2023

Preprint

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Introduction Oesophagectomy is a complex procedure performed for malignant and benign conditions. Post-oesophagectomy conduit dysfunction is common, which can occur for several reasons including conduit dysmotility. However, reliable tools for evaluating conduit motility are lacking. A non-invasive device for gastric electrical mapping was recently developed to evaluate gastric electrical activity and function. This study aimed to assess the feasibility of BSGM in the post-oesophagectomy stomach. Methods Oesophagectomy patients from Auckland, New Zealand, were recruited. The Gastric Alimetry System (New Zealand) was employed, comprising a stretchable array (8x8 electrodes), a wearable Reader, and validated iOS app for symptom logging. The protocol comprised a 30-minute baseline, a meal challenge, then 4 hours of post-prandial recordings. Analysis encompassed Principal Gastric Frequency, BMI-adjusted amplitude, Gastric Alimetry Rhythm Index (indicating rhythm stability), meal response, and symptoms. Adverse events were recorded. Results 6 patients were recruited and gastric activity was successfully captured in all except one with the colonic interposition (negative control). Four patients showed abnormalities indicating post-operative gastric hypofunction: four with low or abnormal frequency (<2.65 cycles/min), three with low amplitude (<22μV), two with low GA-RI (<0.25) and one with a reduced meal response. One patient had significant symptoms (nausea, early satiation) who demonstrated marked hypomotility in all four of these domains. No adverse events occurred. Conclusion Gastric Alimetry is a safe and feasible technique to non-invasively assess gastric conduit motility following oesophagectomy. Parameters may need adjustment for post-surgical anatomy. Clinical studies assessing the role in diagnosis and therapy can be advanced.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: (Which Was Not Certified By Peer Review)mentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

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Non-invasive thoracoabdominal mapping of post-oesophagectomy conduit function

Wang

Tokhi

Gharibans

et al. 2023

Preprint

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“…Surgery on the stomach has been known to affect the native electrophysiology and thereby affect gastric contraction and motility (6, 9, 20, 21). Despite extensive research into surgical techniques to improve the rates of DGE (eg.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of gastric electrophysiology, symptoms and quality of life after pancreaticoduodenectomy

Wang,

Varghese,

Calder

et al. 2023

Preprint

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BackgroundPancreaticoduodenectomy (PD) is an operation performed for several indications, including pancreatic and biliary malignancies. Delayed gastric emptying (DGE) is a common post-operative complication and the underlying pathophysiology remains poorly understood. This study aimed to evaluate the gastric electrophysiology, symptoms and quality of life following PD, using the novel non-invasive Gastric Alimetry System.MethodsPD patients with index operations between 2017-2022 were assessed using the Gastric Alimetry System®, comprising a stretchable 8×8 electrode array, wearable Reader, and validated symptom logging app. A 30-minute pre-prandial and a 4-hour post-prandial recording was performed. Outcomes included Principal Gastric Frequency, BMI-adjusted amplitude, Gastric Alimetry Rhythm Index, meal response, symptoms, and quality of life (QOL) questionnaires (PAGI-SYM, PAGI-QOL). Data was compared to a validated reference range and matched healthy controls.Results19 patients and 19 matched controls were recruited. There were no differences in any gastric parameters between PD patients and matched controls (allp>0.05). Gastric electrophysiology parameters lay outside normative reference intervals in 8/19 cases, generally being only minor deviations, while significant symptoms occurred in 8/19 (42%); which did not correlate (p=0.43). PD patients had worse quality of life scores than controls (p<0.01), however, no correlations were identified between electrophysiological parameters and QOL.DiscussionModerate to severe upper GI symptoms are common after PD with worse QOL compared to the controls. Gastric electrical activity generally recovers well long-term following PD, indicating that other factors contribute to symptoms. Further studies should now assess acute changes in gastric function after PD.

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