Year 2015 Vol. 23 No 1

GENERAL AND SPECIAL SURGERY

P.M. KOSENKO 1, S.A. VAVRINCHUK1, L.K. KULIKOV2

EVALUATION OF ELECTROPHYSIOLOGICAL INDICATORS OF COMPENSATION MOTILITY OF STOMACH IN PATIENTS WITH ULCER PYLORODUODENAL STENOSIS

SBEE HPE "Far East State Medical University" 1, Khabarovsk
SBEE APE "Irkutsk State Medical Academy of Post-graduate Education" 2

Objectives. To determine electrophysiological criteria of compensation motility of stomach in patients with ulcer pyloroduodenal stenosis according to the peripheral electrogastroenterography.
Methods. 57 patients with ulcer pyloroduodenal stenosis (PDS) have been examined and subdivided into 3 groups on the basis of compensation degree. Compensated PDS was diagnosed in 25 (43,8%) patients, subcompensated PDS – in 24 (42,1%) and decompensated one – in 8 (14,1%) patients. Control group consisted of 28 healthy persons; 28 patients with subcompensated PDS were enrolled in the main group. Evaluation of the gastrointestinal motor activity was performed using the peripheral electrogastroenterography method.
Results. It is found that the group of patients with subcompensated stenosis combines patients with both compensated (hypermotor type) and decompensated (hypomotor type) gastric motility. In patients with hypermotor type of subcompensated stenosis, maximal degree of compensation of gastric motility was observed; on the contrary, in the pre- and postoperative periods in patients with hypomotor type of subcompensated stenosis the signs of decompensation of gastric motility were revealed.
The most significant manifestation of decompensation of stomach motorics in patients with the ulcer pyloroduodenal stenosis was the reduction of the electric (Pi) and peristaltic activity of the stomach more than twice after food stimulation relatively to the basal values.
Conclusion. Based on the obtained results two new electrophysiological ices were proposed – «index of compensation of electric gastric motility» which is the ratio of the stimulated electric stomach activity values to its basal value, and “index of compensation of stomach peristaltic motility” which is the ratio of the stimulated coefficient of gastric rhythm values to its basal value and which characterizes the stomach peristaltic activity. Informativeness of the proposed indicators has proved by mathematical modeling based on discriminant analysis (prediction accuracy – 81,1%), as well as the identified correlation between the proposed values and the degree of stenosis compensation.

Keywords: ulcer, duodenal stenosis, electrogastroenterogram, gastric motility, mathematical modeling, discriminant analysis
p. 30-36 of the original issue
References
  1. Rukhliada NV, Nazarov VE, Ermolaev IA. Diagnostika i lechenie iazvennoi bolezni, oslozhnennoi stenozom [Diagnosis and treatment of peptic ulcer complicated by stenosis]. Saint-Petersburg, RF: DEAN; 2006. 240 p.
  2. Pantsyrev IuM, Cherniakevich SA, Mikhalev AI. Khirurgicheskoe lechenie iazvennogo piloroduodenal'nogo stenoza [Surgical treatment of ulcerative pyloroduodenal stenosis]. Khirurgiia. Zhurn im NI Pirogova. 2003;(2):18-21.
  3. Chernousov AF. Selektivnaia proksimal'naia vagotomiia [Selective proximal vagotomy]. Moscow, RF: IzdAT, 2001. 160 p.
  4. Durleshter VM, Didigov MT. Khirurgicheskoe lechenie dekompensirovannogo rubtsovo-iazvennogo stenoza (obzor literatury) [Surgical treatment of decompensated scar-ulcerative stenosis (review)]. Vestn Khirurg Gastroenterologii. 2009;(2):59-66.
  5. Stupin VA, Smirnova GO, Baglaenko MV, Siluianov SV. Perifericheskaia elektrogastroenterografiia v diagnostike narushenii motorno-evakuatornoi funktsii zheludochno-kishechnogo trakta [Peripheral electrogastrogram in the diagnosis of motor-evacuation function of the gastrointestinal tract]. Lech Vrach. 2005;(2):60-62.
  6. Tropskaia NS, Vasil'ev VA, Popova TS, Ishmukhametov AI, Azarov IaB, Li LG. Teoreticheskie predposylki i eksperimental'noe obosnovanie ispol'zovaniia elektrogastro-enterografii [Theoretical background and experimental study of electrogastrogram application]. Ross Zhurn Gastroenterologii Gepatologii i Koloproktologii. 2005;(5):82-88.
  7. Matsuura Y, Yamamoto T, Takada M, Shiozawa T, Takada H. Application of electrogastrography to public health. Nihon Eiseigaku Zasshi (Japanese Journal of Hygiene). 2011 Jan;66(1):54-63.
  8. Yin J, Chen JD.Electrogastrography: methodology, validation and applications. J Neurogastroenterol Motil. 2013 Jan;19(1):5-17.
  9. Angeli TR, Du P, Paskaranandavadivel N, Janssen PW, Beyder A, Lentle RG, Bissett IP, Cheng LK, O'Grady G.The bioelectrical basis and validity of gastrointestinal extracellular slow wave recordings. J Physiol. 2013 Sep 15;591(Pt 18):4567-79.
  10. Banerzhi A. Leonov VP/ red. Meditsinskaia statistika poniatnym iazykom [Medical statistics by understandable language]: vvodnyi kurs. Moscow, RF: Prakt Meditsina, 2014. 287 p.
  11. Smirnova GO. Siluianov SV. Stupin VA / red. Perifericheskaia elektrogastroenterografiia v kliniche¬skoi praktike [Peripheral electrogastroenterography in clinical practice]. Posobie dlia vrachei, Moscow, RF: ID Medpraktika-M; 2009. 20 p.
Address for correspondence:
680000, Rossiyskaya Federatsiya,
g. Habarovsk, ul. Muraveva-Amurskogo, d. 35,
GBOU VPO "Dalnevostochnyiy gosudarstvennyiy
meditsinskiy universitet",
kafedra obschey i fakultetskoy khirurgii,
tel. office: 7 (4212) -30-53-11,
e-mail: kosenko@inbox.ru,
Kosenko Pavel Mihaylovich
Information about the authors:
Kosenko P.M. PhD, an associate professor of the general and faculty chair of SBEE HPE "Far East State Medical University", Khabarovsk.
Vavrinchuk S.A. MD, professor of the surgery chair with the course of endoscopic and plastic surgery of the advanced training and retraining faculty of SBEE HPE "Far East State Medical University", Khabarovsk.
Kulikov L.K. MD, professor, a head of the surgery chair of SBEE APE "Irkutsk State Medical Academy of Post-graduate Education".
Contacts | ©Vitebsk State Medical University, 2007-2023