THE PHYSICAL AND MATHEMATICAL MODEL OF INTRATHORACIC STOMACH USED FOR ESOPHAGOGASTROPLASTY: II. THE STOMACH TRANSPLANT WIDTH AND PYLORIC DRAINAGE PROCEDURE IMPACT ON GASTRIC EMPTYING TIME

Introduction. There are limited data concerning food transportation through the intrathoracic stomach used for esophageal replacement after resection. Bilateral truncal vagotomy and partial sympathectomy make the stomach transplant act as an inert tube; although, food moves only by gravitation force there. Purpose. After previous application of the basic physical and mathematical model of the intrathoracic stomach, I assumed that further assessment of the gastroplasty model width and diameter of pyloric canal should be performed. Materials and methods. The gastric tube models with the three different diameters of 30 mm (prototype is narrow gastric tube); 60 mm (prototype ? wide gastric tube) and 90 mm (prototype ? the whole stomach) were produced and connected to the three variants of pyloric canal model (3.5 mm vs 7.0 mm vs 14.0 mm). I calculated the transportation time through physical models for 250 ml of water and 50 % glycerin. I analyzed either additional negative chest pressure and positive intraabdominal pressure had effect on the liquids emptying time. Results. The obtained results showed that the time periods of water emptying for 90 mm gastric tube were 63.3 ± 2.0; 15.0 ± 1.3 and 3.4 ± 1.0 seconds for 3.5 mm; 7.0 mm and 14 mm pyloric canal models respectively; the time periods of water emptying for 60 mm gastric tube were 38.8 ± 1.1; 9.8 ± 0.8 and 2.4 ± 0.8 seconds for 3.5 mm; 7.0 mm and 14 mm pyloric canal models respectively; and the time periods of water emptying for 30 mm gastric tube were 19.7 ± 2.1; 5.3 ± 1.9 and 1.3 ± 0.8 seconds for 3.5 mm; 7.0 mm and 14 mm pyloric canal models respectively. The term of glycerin transportation was significantly higher comparing with water transportation through the model (3.2?3.4 odd). Additional negative chest pressure and positive intraabdominal pressure had no effect on the liquids evacuation time. Discussion: Emptying time equation for intrathoracic stomach model was calculated and compared with data obtained from physical model exploration. I assumed that the width stomach transplant defined the emptying time regardless fluid consistency. I emphasized on the necessity of wide gastric tube esophageal replacement and digital pyloric rupture at clinical setting.