Title: Effects of different procedures of esophagectomy on gastroesophageal reflux in patients with esophageal neoplasms
Abstract: Objective To investigate the prevalence of gatroesophageal reflux in patients with esophagectomy for esophageal neoplasms,and provide evidences for the choice of surgical procedures.Methods According to surgical procedures,85 patients with esophageal neoplasms who underwent esophagectomy were divided into two groups:group of anastomosis above the aortic arch(n=52)and group of anastomosis below the aortic arch(n=33).Another 30 people screened by gastroendoscope were served as controls.24 h esophageal pH monitoring,electronic gastroscopy,pathological examination and DeMeester scoring system for assessment of heartburn were employed to evaluate the effects of reflux on remnant esophagus in the two groups of patients with esophageal neoplasms,and 24 h esophageal pH monitoring was conducted in the controls.Results It was revealed by 24 h pH monitoring that the parameters in group of anastomosis above the aortic arch and group of anastomosis below the aortic arch were significantly higher than those in control group(P0.01).For pH less than 4,the cumulative time,time of supine,times of reflux,times of reflux for more than 5 min and time of longest reflux in group of anastomosis above the aortic arch were significantly lower than those in group of anastomosis below the aortic arch(P0.05).It was indicated by endoscopy and pathologcial examinations that the prevalences of esophagitis were significantly lower in group of anastomosis above the aortic arch than those in group of anastomosis below the aortic arch(30.77% vs 54.55%,P0.05),and the same findings were observed by esophagitis scoring(0.46±0.53 vs 1.18±1.05,P0.05).Heartburn was significantly less prevalent in group of anastomosis above the aortic arch than in group of anastomosis below the aortic arch(48.08% vs 78.79%,P0.05),and the same findings were observed by the heartburn scoring(0.65±0.23 vs 1.89±1.25,P0.05).Conclusion Gatroesophageal reflux is frequently found after esophagectomy for esophageal neoplasms,and the procedure with anastomosis above the aortic arch may lead to less severe gatroesophageal reflux than that with anastomosis below the aortic arch.
Publication Year: 2009
Publication Date: 2009-01-01
Language: en
Type: article
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