Reduction of lower esophageal sphincter pressure with Stamm gastrostomy. 1987

D F Canal, and D W Vane, and S Goto, and G P Gardner, and J L Grosfeld

Although recent clinical studies suggest an association between Stamm gastrostomy and gastroesophageal reflux (GER), no significant experimental data is available. This study evaluates alterations in lower esophageal sphincter (LES) pressure after Stamm gastrostomy in cats. Eight male cats (average weight 3 to 4 kg) were induced under general anesthesia using 20/mg/kg ketamine intramuscularly (IM). Esophageal manometrics were determined for each animal using a continuous perfusion catheter and recording system. Three measurements were taken for each animal. Stamm gastrostomy was then placed in the anterior wall of the stomach two thirds of the way down from the fundus. This was tacked to the anterior abdominal wall 3.0 cm lateral to the midline at the appropriate longitudinal level. Esophageal manometry was repeated after abdominal closure. The animals were awakened and returned to their cages for ad libidum feedings. The animals were reanesthetized with ketamine and manometrics repeated at 7 and 14 days. Each animal served as its own control. Five animals underwent barium esophagram 14 days postoperatively to evaluate for GER. Preoperative mean LES pressure measured 11.4 +/- 3.5 torr. This decreased to 7.8 +/- 2.8 torr immediately after Stamm gastrostomy (P less than .025). When evaluated at 1 and 2 weeks after gastrostomy, further decrease in LES pressures to 6.6 +/- 1.6 torr and 4.8 +/- 1.6 was observed (P less than .02 v preoperative). Three of five cats undergoing barium swallow demonstrated significant reflux radiographically. Stamm gastrostomy caused significant reduction of the LES pressure in all cats studied. This resulted in clinical GER as documented by barium swallow in three of five cats.(ABSTRACT TRUNCATED AT 250 WORDS)

UI MeSH Term Description Entries
D011312 Pressure A type of stress exerted uniformly in all directions. Its measure is the force exerted per unit area. (McGraw-Hill Dictionary of Scientific and Technical Terms, 6th ed) Pressures
D002415 Cats The domestic cat, Felis catus, of the carnivore family FELIDAE, comprising over 30 different breeds. The domestic cat is descended primarily from the wild cat of Africa and extreme southwestern Asia. Though probably present in towns in Palestine as long ago as 7000 years, actual domestication occurred in Egypt about 4000 years ago. (From Walker's Mammals of the World, 6th ed, p801) Felis catus,Felis domesticus,Domestic Cats,Felis domestica,Felis sylvestris catus,Cat,Cat, Domestic,Cats, Domestic,Domestic Cat
D004935 Esophageal Diseases Pathological processes in the ESOPHAGUS. Disease, Esophageal,Diseases, Esophageal,Esophageal Disease
D004943 Esophagogastric Junction The area covering the terminal portion of ESOPHAGUS and the beginning of STOMACH at the cardiac orifice. Gastroesophageal Junction,Gastroesophageal Junctions,Junction, Esophagogastric,Junction, Gastroesophageal,Junctions, Gastroesophageal
D005764 Gastroesophageal Reflux Retrograde flow of gastric juice (GASTRIC ACID) and/or duodenal contents (BILE ACIDS; PANCREATIC JUICE) into the distal ESOPHAGUS, commonly due to incompetence of the LOWER ESOPHAGEAL SPHINCTER. Esophageal Reflux,Gastro-Esophageal Reflux Disease,GERD,Gastric Acid Reflux,Gastric Acid Reflux Disease,Gastro-Esophageal Reflux,Gastro-oesophageal Reflux,Gastroesophageal Reflux Disease,Reflux, Gastroesophageal,Acid Reflux, Gastric,Gastro Esophageal Reflux,Gastro Esophageal Reflux Disease,Gastro oesophageal Reflux,Gastro-Esophageal Reflux Diseases,Reflux Disease, Gastro-Esophageal,Reflux, Gastric Acid,Reflux, Gastro-Esophageal,Reflux, Gastro-oesophageal
D005774 Gastrostomy Creation of an artificial external opening into the stomach for nutritional support or gastrointestinal compression. Gastrostomies
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia

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