Journal
HEPATO-GASTROENTEROLOGY
Volume 59, Issue 119, Pages 2339-2342Publisher
H G E UPDATE MEDICAL PUBLISHING S A
DOI: 10.5754/hge10384
Keywords
Lower esophageal sphincter; Total gastrectomy reconstructed by Roux-en-Y; Esophageal manometry; Alkali reflux esophagitis
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Background/Aims: Physiological assessments in patients with or without preserved lower esophageal sphincter (LES) after total gastrectomy reconstructed by Roux-en-Y (TGRY) are still inconclusive. This study aims to clarify the significance of LES functions in patients, especially prevention of alkali reflux esophagitis (ARE) after TGRY for gastric cancer. Methodology: Forty-eight patients after TGRY were divided into 2 groups. Group A: 20 patients without preserved LES and group B: 28 patients with preserved LES, and compared with 20 control subjects. The mean follow-up time from operation of TGRY was 27.1 months. Post-operative interview and endoscopic findings for ARE were conducted and esophageal manometry was performed on all patients in order to assess length of LES (LLES; cm) and maximum LES pressure (MLESP; mmHg). Results: Both symptoms and endoscopic findings for ARE in group A were significantly higher than those in group B. The LLES in group A was significantly shorter than that in groups B and C. The MLESP in group A was significantly lower than in groups B and C. Conclusions: ARE after TGRY is due to an impairment of LES functions. Preservation of the LES may be necessary to prevent ARE after TGRY.
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