Endoscopic Evaluation of Reflux Esophagitis After Proximal Gastrectomy: Comparison Between Esophagogastric Anastomosis and Jejunal Interposition

Background Although proximal gastrectomy has been performed more as a function-preserving surgery, reflux esophagitis can occur postoperatively, resulting in poor postoperative quality of life. To date, only a few reports have compared the methods of reconstruction performed after proximal gastrecto...

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Bibliographic Details
Published in:World journal of surgery 2008-07, Vol.32 (7), p.1473-1477
Main Authors: Tokunaga, Masanori, Ohyama, Shigekazu, Hiki, Naoki, Hoshino, Etsuo, Nunobe, Souya, Fukunaga, Tetsu, Seto, Yasuyuki, Yamaguchi, Toshiharu
Format: Article
Language:English
Subjects:
Abdominal Surgery
Anastomosis, Surgical
Biological and medical sciences
Cardiac Surgery
Early Gastric Cancer
Esophagitis, Peptic - diagnosis
Esophagitis, Peptic - etiology
Esophagoscopy
Esophagus
Esophagus - surgery
Female
Gastrectomy - adverse effects
Gastrectomy - methods
Gastroenterology. Liver. Pancreas. Abdomen
General aspects
General Surgery
Humans
Jejunum - surgery
Male
Medical sciences
Medicine
Medicine & Public Health
Middle Aged
Other diseases. Semiology
Reconstruction Method
Reflux Esophagitis
Remnant Stomach
Retrospective Studies
Stomach - surgery
Surgery
Thoracic Surgery
Vagal Nerve
Vascular Surgery
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Summary:Background Although proximal gastrectomy has been performed more as a function-preserving surgery, reflux esophagitis can occur postoperatively, resulting in poor postoperative quality of life. To date, only a few reports have compared the methods of reconstruction performed after proximal gastrectomy, and the method most likely to prevent postoperative reflux esophagitis remains undetermined. Methods A retrospective review of 76 patients who underwent proximal gastrectomy with jejunal interposition (JI) or esophagogastrostomy (EG) at the Cancer Institute Hospital between April 1996 and August 2005 was performed. Preoperative characteristics, operative findings, and postoperative gastrointestinal fiberoscopy findings were reviewed and compared between JI and EG patients. Furthermore, we investigated the relationship between the length of interposed segment and operative and postoperative findings. Results The frequency of grade C or D reflux esophagitis was lower in the JI group than in the EG group ( p  = 0.001), although the former required a longer operation time (256.5 ± 10.2 min) than the latter (195.8 ± 8.2 min; p  
ISSN:0364-2313
1432-2323
DOI:10.1007/s00268-007-9459-7