None listed
Conditions
Brief summary
BACKGROUND Patients who undergo major upper gastro-intestinal surgery, such as oesophageal reconstruction or bariatric surgery, have substantially altered stomach and oesophageal anatomy, and therefore both oesophageal transit and gastric emptying are much different. Altered sensations and symptoms, such as reflux, regurgitation and nausea, are sometimes reported by patients. These symptoms are known to be a major determinant of the overall outcome of the procedure and significantly affect patients’ quality of life. Currently, there are few accurate tests able to assess the function of the stomach and oesophagus after major upper gastro-intestinal surgery. Nuclear scintigraphy is a functional test that has considerable utility in the assessment of gastric emptying and oesophageal transit. Observed function can be correlated with outcomes and symptoms. Scintigraphy is well established in assessing symptoms of reflux, swallowing and suspected alterations in gastric emptying. AIMS In this study we aim to establish the normal gastro-intestinal transit function in patients following major upper gastro-intestinal surgery and also correlate the physiology of transit, and emptying with reported levels of reflux, regurgitation and satiety. The aim is to: 1) Establish normative values and determine the expected pattern of oesophageal transit, gastric emptying and small bowel transit following upper gastrointestinal surgery 2) Determine if the patterns of oesophageal transit and gastric emptying and change over time following major upper gastro-intestinal surgery HYPOTHESIS A differing pattern of oesophageal transit, gastric and intestinal transit is observed following upper gastro-intestinal surgery. This patterns changes substantially over the first year following surgery and then stabilises. BRIEF METHODS Patients will be recruited prior to their major upper gastrointestinal surgery (oesophageal or gastric resection, or sleeve gastrectomy). They will undergo 4 nuclear scintigraphy scans after their operations to establish the new function of the reconstructed upper gastrointestinal tract, and correlated these with symptoms, as assessed by validated questionnaires.
Interventions
Patients who have undergone major upper gastrointestinal surgery (oesophageal resection, gastric resection, sleeve gastrectomy) will be recruited to undergo nuclear scintigraphy (nuclear medicine scans) to examine their oesophageal transit and gastric emptying. These scans will be repeated over 2 years to observe any changes in function (e.g. return to normal function).
Scans will be done at 4 weeks after surgery, 6 months, 12 months and 24 months. Each nuclear medicine scan will take about tw
Patients who have undergone major upper gastrointestinal surgery (oesophageal resection, gastric resection, sleeve gastrectomy) will be recruited to undergo nuclear scintigraphy (nuclear medicine scans) to examine their oesophageal transit and gastric emptying. These scans will be repeated over 2 years to observe any changes in function (e.g. return to normal function). Scans will be done at 4 weeks after surgery, 6 months, 12 months and 24 months. Each nuclear medicine scan will take about two hours. Patients will then be asked to swallow a mouthful of porridge twice while sitting in front of the camera. Following which they will be given 3/4 of a cup of porridge to which has been mixed with some radioactive marker that can be detected by the scanners. They will then lie down for the remainder of the study with images being taken for about 90 minutes. Scans results will be correlated to symptoms, assessed by validated questionnaires done at the same time as the scans.
Sponsors
The Alfred Hospital
Eligibility
Sex/Gender
All
Age
18 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
Patients consist of two groups: Group 1: Oesophageal reconstruction group Group 2: Sleeve gastrectomy (bariatric surgical) group These patients are recruited prospectively, to allow inclusion of 6 week post-operative scan.
Exclusion criteria
Pregnancy or breastfeeding
Outcome results
None listed