Functional evaluation of esophageal substitutes.

BACKGROUND: The function of esophageal Substitutes is not comparable to the normal esophagus. METHODS: To clarify the difference between esophageal substitutes and the normal esophagus, radionuclide scintigraphy and clinical assessment were used as study methods. The study was conducted in groups of substernal colon (n = 9), substernal ileocolon (n = 6), posterior mediastinal colon (n = 6) and posterior mediastinal gastric tube (n = 14). The control group consisted of normal volunteers (n = 8). RESULTS: Patients with substernal ileocolon did not experience nocturnal regurgitation, which occurred often in other groups. All esophageal substitutes had a decreased clearance ability compared to the normal esophagus. Among these substitutes, the posterior mediastinal gastric tube had the shortest swallowing time, while the substernal ileocolon had the longest. The substernal colon had a significantly prolonged transit time. Among these study groups, neither differences of clearance ability nor those of alimentary reflux reached statistical significance. CONCLUSIONS: From the view point of food transit, it is suggested that a posterior mediastinal gastric tube or posterior mediastinal colon is the first choice of esophageal substitute.