Gastric Functions in Patients with the Intrathoracic Stomach after Esophageal Surgery

Okada, Naniwa; Nishimura, Osamu; Sakurai, Takeo; Tsuchihashi, S; Juhri, M

doi:10.1097/00000658-198608000-00003

Cited by 41 publications

(32 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although commonly reported after gastrectomy [13][14][15], little is known regarding the prevalence and implications of micronutrient deficiency after esophagectomy. Whilst previous studies have focused on aspects related to micronutrient intake and absorption after esophagectomy, they do so without direct correlation to blood levels [6][7][8]16]. Wang et al reported a persistent decrease in Zinc levels after esophagectomy [9], a finding that was corroborated by the current study.…”

Section: Discussionsupporting

confidence: 77%

“…Whilst Haverkort et al determined suboptimal intake of micronutrients in 90% of patients following esophagectomy [6], this study did not correlate the observed low intake of these micronutrients to levels within patients' blood. Similarly, Okada et al [7] and Hjelms et al [8] reported normal vitamin B12 absorption in patients following esophagectomy, but neither study measured bloods levels of this vitamin. Wang et al reported reduced Iron and Zinc levels in the first three months after esophagectomy with only iron levels returning to baseline after this period [9].…”

Section: Introductionmentioning

confidence: 96%

See 1 more Smart Citation

Micronutrient Deficiency Following Esophagectomy for Cancer of the Upper Gastrointestinal Tract

Boshier¹,

Wakefield²,

Hickson³

et al. 2017

Vitam Miner

View full text Add to dashboard Cite

Objectives: For those patients who achieve long-term survival following esophagectomy, altered digestion and malabsorption may lead to a range of adverse gastrointestinal sequelae, including micronutrient deficiencies. The aim of the current study was to determine the prevalence of specific micronutrient deficiencies in patients following esophagectomy.Methods: Levels of vitamin A, vitamin E, vitamin D, vitamin B1, vitamin B12, folate, ferritin, zinc and calcium were measured in a single non-fasting blood sample in patients who had undergone esophagectomy. Findings were compared to both patients who had undergone gastrectomy and an age matched Western control population.Results: Forty-Four patients (33 male, 65.5 ± 10.2 yrs) a median of 26 months (IQR 12-46) following either two or three stage esophagectomy were recruited. Deficiency in one or more micronutrients was observed in 64% of patients who underwent esophagectomy. Micronutrients most commonly deficient following esophagectomy were vitamin D (21%), vitamin B12 (32%), ferritin (16%) and zinc (25%). Compared to patients who underwent gastrectomy, levels of vitamin B12 and red cell folate were significantly lower, and levels of vitamin E were significantly higher in the blood of patients following esophagetomy. Compared to a Western control population the mean levels of vitamins A, E, D and B12, ferritin and zinc were lower in patients following esophagectomy. Conclusion:Micronutrient deficiency is common after esophagectomy affecting two thirds of all patients. Regular screening of vitamin D, vitamin B12, ferritin and Zinc levels should be considered as well as prophylactic supplementation in this patient group to prevent deficiency.

show abstract

Section: Discussionsupporting

confidence: 77%

Section: Introductionmentioning

confidence: 96%

Micronutrient Deficiency Following Esophagectomy for Cancer of the Upper Gastrointestinal Tract

Boshier¹,

Wakefield²,

Hickson³

et al. 2017

Vitam Miner

View full text Add to dashboard Cite

show abstract

“…Thus, a positive Congo red test was found to be more common in patients with more than 5 years of follow-up than in those investigated earlier. 4 Likewise, comparison of data from two series of gastric transplant patients 2,3 indicates that the prevalence of cervical heartburn and endoscopic inflamma-tion in the esophageal remnant on the one hand and exposure of the latter to acid on the other are higher in patients with more than 1 year of follow-up than in those studied 6 to 12 months after surgery. Moreover, according to the well-known functional parallelism between the submucous and myenteric plexuses of the stomach, 5 the spontaneous motor recovery process we have found in the denervated whole stomach as an esophageal substitute 6,7 also bears out the hypothesis that acid secretion may recover with time.…”

Section: Discussionmentioning

confidence: 99%

Denervated Stomach as an Esophageal Substitute Recovers Intraluminal Acidity With Time

Gutschow¹,

Collard²,

Romagnoli³

et al. 2001

Annals of Surgery

View full text Add to dashboard Cite

ObjectiveTo determine whether the denervated stomach as an esophageal substitute recovers normal intraluminal acidity with time. Summary Background DataBilateral truncal vagotomy to the stomach as an esophageal substitute reduces both gastric acid production and antral motility, but a spontaneous motor recovery process takes place over years. MethodsIntraluminal gastric pH and bile were monitored during a 24-hour period 1 to 195 months after transthoracic elevation of the stomach as esophageal replacement in 91 and 76 patients, respectively. Nine patients underwent a second gastric pH monitoring after a 3-year period. The percentages of time that the gastric pH was less than 2 and bile absorbance exceeded 0.25 were calculated in reference to values from 25 healthy volunteers. Eighty-nine upper gastrointestinal endoscopies were performed in 83 patients. Patients were divided into three groups depending on length of follow-up: group 1, less than 1 year; group 2, 1 to 3 years; group 3, more than 3 years.

show abstract

“…The first evidence of normal morphological structural restoration and independence from external inputs is electronomicroscopically identified and confirmed by pH-metric evaluation/ 24h (16,(24)(25)(26).…”

Section: Discussionmentioning

confidence: 83%

Esophageal Reconstruction with the Stomach, a Functional Dilemma?

Predescu¹,

Constantinoiu²

2018

chr

View full text Add to dashboard Cite

RezumatÎn urmă cu câteva decade, substituţia esofagiană se adresa în special cazurilor de stenoze esofagiene postcaustice; actual, reconstrucţia şi-a lărgit paleta indicaţiei şi pentru alte domenii din patologia esofagiană benignă (tulburări motorii severe, acalazie multi-recidivată, stenoze peptice, etc.) dar a devenit şi un timp final cvasi-obligatoriu în exereza esofagiană pentru cancer ori de câte ori gestul este posibil. Tehnicile de reconstrucţie esofagiană ce folosesc potenţialul visceral al stomacului, indiferent de indicaţie şi varianta tehnică aleasă, rămân o metodă valoroasă şi eficace. O serie de argumente redutabile pledează pentru un tip sau altul de grefon gastric: factori anatomici mai mult decât convenabili (vascularizaţie, lungime suficientă, structură parietală competentă pentru sutură, etc.) şi un act operator sustenabil (durată, abord, complexitate timpi operatori, tulburări digestive post-grefare, funcţionalitate postterapeutică, etc). Opţiunea pentru o tehnică sau alta, dincolo de argumente patologice, trebuie să ţină cont de funcţionalitatea la distanţă, cu evident impact pe status-ul metabolic şi calitatea vieţii. Deci putem argumenta funcţional un montaj gastric sau altul funcţie de acest criteriu? În final, dovada unei rezolvări adecvate este relativ facil de apreciat: a fost restabilită deglutiţia şi dacă da, rezultatul s-a menţinut în timp? Pentru cazurile oncologice evaluarea trebuie să ţină seama şi de criteriul cronologic al ratei de supravieţuire postoperatorii. Metodă: Lotul evaluat statistic s-a întins pe perioada 1981 -2016 şi a cuprins un număr de 268 de pacienţi operaţi pentru stenoze esofagiene, repartizaţi în funcţie de etiopatogenie şi indicaţie în 201 de reconstrucţii pentru cauze stenotice post-caustice şi 67 pentru substituţie post-ablativă de cauză neoplazică. Tehnicile utilizate pentru evaluarea funcţională la distanţă au cuprins: prânz radio-opac, ex.endoscopic + biopsie, iar la cazuri cu modificări evidente pH-metrie/24h şi manometrie şi excepţional scintigrafie cu alimente marcate. Rezultate: Au fost identificate două tipuri de probleme: un tip particular de disfuncţie neuromotorie a substitutului esofagian la 6 pacienţi (1 reconstrucţie tip Gavriliu şi 5 cu tot stomacul Nakayama), evacuarea grefonului fiind dificilă, întârziată, cu stază importantă şi disconfort alimentar (vărsături, inabilitatea alimentaţiei, fenomene aspirative) respectiv o patologie de reflux -8 bolnavi, fiind argumentată de o simptomatologie specifică, de prînzul baritat, de examenul endoscopic şi de examen-ul pH-metric. Refluxul avea un caracter alcalin la 7 pacienţi, toţi cu piloroplastie, 5 cu tot stomacul şi 2 cu procedeu Akiyama iar la 1 caz cu procedeu Gavriliu refluxul era acid. Concluzii: Stomacul este o obţiune redutabilă în substituţia esofagiană. În ceea ce priveşte rezultatele la distanţă se constată o funcţionalitate bună, cu un status metabolic rezonabil. Cele două fenomene de care depinde funcţional grefonul -activitate secretorie şi activitate motorie -par a se restabili odată...

show abstract

Gastric Functions in Patients with the Intrathoracic Stomach after Esophageal Surgery

Cited by 41 publications

References 17 publications

Micronutrient Deficiency Following Esophagectomy for Cancer of the Upper Gastrointestinal Tract

Micronutrient Deficiency Following Esophagectomy for Cancer of the Upper Gastrointestinal Tract

Denervated Stomach as an Esophageal Substitute Recovers Intraluminal Acidity With Time

Esophageal Reconstruction with the Stomach, a Functional Dilemma?

Contact Info

Product

Resources

About