Esophageal Reconstruction with the Pedunculated Colonic Tube : Postoperative Problems, Especially Motor Functions of the Colonic Tube

In 65 cases who had undergone esophageal reconstruction with the pedunculated colonic tube, intraluminal manometry and scintiscanning of the pedunculated colonic tube were performed. The author came to the conclusions as follows : (1) The pedunculated colonic tube conducted a part of swallowing waves. In these waves, the author recognized the characteristic conduction waves, similar to the colonic type IV waves, classified by Code. et al. (2) The colonic type IV waves were declined in their frequency and wave speed, compared with the esophageal swallowing waves. (3) The water swallowing waves elevated more favorably swallowing conduction rate as compared with the dry swallowing waves. (4) Under the provocation of tetragastrine (5μg/kg, i. v.) the pedunculated colonic tube elevated its resting pressure and swallowing pressure more favorably, except for the increase of wave frequency. (5) According to the analysis of the coloscintigram, the author recognized that in the cases of pharyngo-colo-gastrostomy, the greater part of the solid meals passed very slowly, on the other hand, in the cases of cervical esophago-colo-duodenostomy, solid meals passed down to the duodenum very quickly. (6) In the endoscopic findings, regurgitation from the stomach to the interposed colonic tube was sometimes recognized. (7) The incidence of leakage was more evident in cervical esophago-colostomy than pharyngo-colostomy. However, among every anastomosis there were no remarkable differences in the occurrence of anastomotic breakdown.