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Alteration of the Roux Stasis syndrome by an isolated Roux limb: correlation of slow waves and clinical course.
Am Surg. 1999 Jul; 65(7):666-72.AS

Abstract

The Roux-Y stasis syndrome after antrectomy and vagotomy has been well described. Delayed gastric emptying after vagotomy and antrectomy with Roux-Y anastomosis has been attributed to loss of the duodenal pacemaker and to the effects of retrograde slow-wave activity arising from distal small bowel pacemakers. Small bowel contractions are closely coupled with slow-wave activity. Transection and anastomosis of the small bowel distal to the jejuno-jejunostomy has been shown to electrically isolate the Roux limb from distal small bowel pacemakers. Using a canine model, a vagotomy and hemigastrectomy with Roux-Y were performed in five dogs using the standard operation (control); in four dogs (experimental), an additional transection and reanastomosis of the jejunum 25 cm distal to the Y anastomosis of the Roux limb was performed. All specimens had six electrodes implanted along the Roux limb at 5-cm intervals, used for weekly analysis of the jejunal slow-wave activity. The isolated loop cohort had reduced incidence of retrograde slow waves, reduced emesis, improved gastric emptying by upper gastrointestinal series, and reduced gastric pouch size at autopsy. Adding a distal transection and anastomosis, thus creating an isolated Roux-Y segment, may improve the course of the Roux stasis syndrome.

Authors+Show Affiliations

St. John Hospital and Medical Center, Detroit, Michigan, USA.No affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

10399977

Citation

Zonca, S, and P Rizzo. "Alteration of the Roux Stasis Syndrome By an Isolated Roux Limb: Correlation of Slow Waves and Clinical Course." The American Surgeon, vol. 65, no. 7, 1999, pp. 666-72.
Zonca S, Rizzo P. Alteration of the Roux Stasis syndrome by an isolated Roux limb: correlation of slow waves and clinical course. Am Surg. 1999;65(7):666-72.
Zonca, S., & Rizzo, P. (1999). Alteration of the Roux Stasis syndrome by an isolated Roux limb: correlation of slow waves and clinical course. The American Surgeon, 65(7), 666-72.
Zonca S, Rizzo P. Alteration of the Roux Stasis Syndrome By an Isolated Roux Limb: Correlation of Slow Waves and Clinical Course. Am Surg. 1999;65(7):666-72. PubMed PMID: 10399977.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Alteration of the Roux Stasis syndrome by an isolated Roux limb: correlation of slow waves and clinical course. AU - Zonca,S, AU - Rizzo,P, PY - 1999/7/10/pubmed PY - 1999/7/10/medline PY - 1999/7/10/entrez SP - 666 EP - 72 JF - The American surgeon JO - Am Surg VL - 65 IS - 7 N2 - The Roux-Y stasis syndrome after antrectomy and vagotomy has been well described. Delayed gastric emptying after vagotomy and antrectomy with Roux-Y anastomosis has been attributed to loss of the duodenal pacemaker and to the effects of retrograde slow-wave activity arising from distal small bowel pacemakers. Small bowel contractions are closely coupled with slow-wave activity. Transection and anastomosis of the small bowel distal to the jejuno-jejunostomy has been shown to electrically isolate the Roux limb from distal small bowel pacemakers. Using a canine model, a vagotomy and hemigastrectomy with Roux-Y were performed in five dogs using the standard operation (control); in four dogs (experimental), an additional transection and reanastomosis of the jejunum 25 cm distal to the Y anastomosis of the Roux limb was performed. All specimens had six electrodes implanted along the Roux limb at 5-cm intervals, used for weekly analysis of the jejunal slow-wave activity. The isolated loop cohort had reduced incidence of retrograde slow waves, reduced emesis, improved gastric emptying by upper gastrointestinal series, and reduced gastric pouch size at autopsy. Adding a distal transection and anastomosis, thus creating an isolated Roux-Y segment, may improve the course of the Roux stasis syndrome. SN - 0003-1348 UR - https://www.unboundmedicine.com/medline/citation/10399977/Alteration_of_the_Roux_Stasis_syndrome_by_an_isolated_Roux_limb:_correlation_of_slow_waves_and_clinical_course_ L2 - https://medlineplus.gov/aftersurgery.html DB - PRIME DP - Unbound Medicine ER -