Acid and Duodenogastroesophageal Reflux after Esophagectomy with Gastric Tube Reconstruction

Yuasa, Norihiro; Sasaki, Eiji; Ikeyama, Takashi; Miyake, Hideo; Nimura, Yuji

doi:10.1111/j.1572-0241.2005.41109.x

Cited by 43 publications

(55 citation statements)

References 27 publications

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“…If the esophagus and/or gastric tube cannot be preserved, continuity of the gastrointestinal tract may be reconstructed with, for example, colonic or small bowel interposition [7] . No significant relationship has been found between reflux symptoms, such as heart burn and regurgitation, and endoscopic findings after esophagectomy in the previous reports [3,8] . Patients with denervated stomach may be free from symptoms of gastric ulcer.…”

Section: Discussionmentioning

confidence: 82%

Esophagotracheal fistula caused by gastroesophageal reflux 9 years after esophagectomy

Maruyama

Motoyama²,

Okuyama³

et al. 2007

WJG

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Section: Discussionmentioning

confidence: 82%

Esophagotracheal fistula caused by gastroesophageal reflux 9 years after esophagectomy

Maruyama

Motoyama²,

Okuyama³

et al. 2007

WJG

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“…As a consequence, there has been found up to 20% esophagitis in the cervical esophageal stump during the first year after surgery, and approximately 70% in the seventh year, and the presence of Barrett's esophagus in the cervical stump in up to 27.7% of cases, which is more serious 26,34 . Of course, the destruction of reflux containment mechanisms (loss of inferior esophageal sphincter mechanism, cardia and pylorus), promote mixed reflux (acid and bile), extremely harmful to the esophageal mucosa 36,37 .…”

Section: Discussion Discussion Discussion Discussionmentioning

confidence: 99%

Esophagectomy with gastroplasty in advanced megaesophagus: late results of omeprazole use

Pochini¹,

Gagliardi²,

Júnior³

et al. 2015

Rev. Col. Bras. Cir.

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Objective: To analyze the late results of advanced Chagasic megaesophagus treatment by esophagectomy associated with the use of proton pump inhibitor (omeprazole) as for the incidence of esophagitis and Barrett's esophagus in the remaining stump. Methods : We studied patients with advanced megaesophagus undergoing esophagectomy and transmediastinal esophagogastroplasty. Patients were divided into three groups: A (20) with esophageal replacement by full stomach, without the use of omeprazole; B (20) with esophageal replacement by full stomach, with omeprazole 40 mg/day introduced after the first postoperative endoscopy and maintained for six years; and C (30) with esophageal replacement by gastric tube with use of omeprazole. Dysphagia, weight loss and BMI were clinical parameters we analyzed. Upper gastrointestinal endoscopy was performed in all patients, and determined the height of the anastomosis, the aspect of the mucosa, with special attention to possible injuries arising from gastroesophageal reflux, and the patency of the esophagogastric anastomosis. Results : We studied 50 patients, 28 males (56%) and 22 (44%) females. All underwent endoscopy every year. In the first endoscopy, erosive esophagitis was present in nine patients (18%) and Barrett's esophagus, in four (8%); in the last endoscopy, erosive esophagitis was present in five patients (8%) and Barrett's esophagus in one (2%). When comparing groups B and C, there was no evidence that the manufacturing of a gastric tube reduced esophagitis and Barrett's esophagus. However, when comparing groups A and C, omeprazole use was correlated with reduction of reflux complications such as esophagitis and Barrett's esophagus (p <0.005). Conclusion : The use of omeprazole (40 mg/day) reduced the onset of erosive esophagitis and Barrett's esophagus during the late postoperative period.

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“…Hashimoto et al [12] also noted that gastric acidity d id not decrease after esophagectomy and the postoperative acidity in the gastric tube was high in patients with high preoperative acidity. Yuasa [13] suggested that the simu ltaneous analysis of pH and biliopancreatic reflu x is useful for determin ing the cause of the severity of the mucosal damage in the esophageal remnant. The gastric transplant recuperates its acid production with time.…”

Section: Esophageal Exposure To Acid and Duodenal Juicementioning

confidence: 99%

Duodenogastric Reflux after Esophagectomy and Gastric Interposition

Hashimoto¹

2014

OALib

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Stomach is considered the "gold standard" as an esophageal substitute after esophagectomy. Reflux disease is considered an unavoidable consequence of esophageal resection followed gastric interposition. Reflux esophagitis shows a progression from inflammation to erosions and to the development of columnar lined metaplasia. With the use of a gastric interposition, the m ost popular option to reconstruct the esophagus resected for malignant or benign conditions creates an in vivo model of reflux disease. Gastric interposition is far from ideal as an esophageal substitute. R eflux esophagitis and new columnar lined metaplasia should be seen as a new complication of subtotal esophagectomy.

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Acid and Duodenogastroesophageal Reflux after Esophagectomy with Gastric Tube Reconstruction

Abstract: Reflux symptoms represented a poor indication of esophagitis in patients with esophagectomy and gastric tube reconstruction. Simultaneous 24-h pH and bilirubin monitoring can help in identifying patients at high risk for reflux esophagitis, as well as indicating the cause of esophagitis.

Cited by 43 publications

References 27 publications

Esophagotracheal fistula caused by gastroesophageal reflux 9 years after esophagectomy

Esophagotracheal fistula caused by gastroesophageal reflux 9 years after esophagectomy

Esophagectomy with gastroplasty in advanced megaesophagus: late results of omeprazole use

Duodenogastric Reflux after Esophagectomy and Gastric Interposition

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