A flow visualization model of duodenogastric reflux after esophagectomy with gastric interposition
- Authors
- Park, Chul-Hyun; Lee, Jae-Ik; Sung, Jaeyong; Choi, Sunghoon; Ko, Kwang-Pil
- Issue Date
- 25-Sep-2013
- Publisher
- BMC
- Keywords
- Esophageal surgery; In vitro studies; Quality of life
- Citation
- JOURNAL OF CARDIOTHORACIC SURGERY, v.8
- Journal Title
- JOURNAL OF CARDIOTHORACIC SURGERY
- Volume
- 8
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/14295
- DOI
- 10.1186/1749-8090-8-192
- ISSN
- 1749-8090
- Abstract
- Background: Our goal was to verify surgical factors that affect duodenogastric reflux (DGR) after esophagectomy through the use of a flow visualization model that would mimic an intrathoracic gastric tube. Methods: Transparent gastric tube models for different routes (retrosternal space [RS] and posterior mediastinum [PM]) were fabricated. Various distal pressures were applied to the experimental model filled with water, and the flow was recorded with a high-speed camera. The volume and maximum height of the refluxate through the pylori of two different sizes (7.5 mm, 15 mm) in two different postures (upright, semi-Fowler) was measured by analyzing the video clips. Results: For the large pylorus setting, when the pressures of 20, 30, and 40 mmHg were applied in the upright position, the volumes of the refluxate in the RS/PM tubes were 87.7 +/- 1.1/96.4 +/- 1.7 mL, 150.8 +/- 1.1/158.0 +/- 3.2 mL, and 156.8 +/- 3.3/198.0 +/- 4.7 mL (p < 0.05), and the maximum heights were 101.6 +/- 4.8/113.4 +/- 2.9 mm, 151.4 +/- 2.2/165.4 +/- 1.5 mm, and 166.1 +/- 1.7/193.7 +/- 6.6 mm (p < 0.05). The data for the small pylorus setting or in the semi-Fowler position showed similar tendencies. For any given route, posture or pressure setting, DGR in the large pylorus model was definitively higher than that for small one. Conclusions: This fluid mechanics study demonstrates posterior mediastinal gastric interposition or pyloric drainage procedure, or both, is associated with high reflux of duodenal contents.
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Collections - 의과대학 > 의예과 > 1. Journal Articles
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