Influence of esophageal carcinoma operations on gastroesophageal reflux |
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Authors: | Hu Jian Li Renyuan Sun Li Ni Yiming |
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Affiliation: | a Department of Thoracic and Cardiovascular Surgery, First Hospital, College of Medicine, Zhejiang University, Hangzhou, China b School of Medicine, Hangzhou Normal College, Hangzhou, China |
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Abstract: | BackgroundGastroesophageal reflux occurs more easily after esophageal carcinoma operations. Our objective was to compare the influence of three kinds of esophageal carcinoma operations on reflux.MethodsFrom May 1999 to May 2002, esophageal carcinoma operations were performed on 30 consecutive patients through left thoracotomy, including 10 cases completed with supraaortic, ante-aortic gastroesophageal anastomosis, 10 cases with subaortic gastroesophageal anastomosis, and 10 cases with apicothoracic retro-aortic gastroesophageal anastomosis. A 24-hour esophageal pH was recorded for every patient 3 months after the operation.ResultsThe number of reflux episodes per 24 hours (No. of episodes), the number of reflux episodes greater than or equal to 5 minutes per 24 hours (No. ≥ 5 min), the time in minutes of the longest reflux episode recorded (longest episode) and the cumulative time of the esophageal pH less than 4 (total time that pH < 4) are all beyond normal limits. The difference in number of episodes between supraaortic, ante-aortic, and subaortic gastroesophageal anastomosis groups is not significant; but the other indexes are higher in the supraaortic, ante-aortic anastomosis group with significance (p < 0.05). The difference in number of episodes between supraaortic, ante-aortic, and apicothoracic retro-aortic gastroesophageal anastomosis groups is not significant while the other indexes are much higher in the supraaortic, ante-aortic anastomosis group with significance (p < 0.05); the difference in number of episodes between apicothoracic retro-aortic and subaortic gastroesophageal anastomosis groups is not significant while the other indexes are lower in the apicothoracic retro-aortic anastomosis group with significance (p < 0.05).ConclusionsGastroesophageal reflux occurred after all three types of esophageal carcinoma operations. The reflux is less severe in the apicothoracic retro-aortic anastomosis group than in the other two groups. The esophageal carcinoma operation with apicothoracic retro-aortic gastroesophageal anastomosis has more advantages to alleviate postoperative gastroesophageal reflux. |
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Keywords: | 7 |
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