Comparison of mucosal reflux damage in remnant esophagus after esophagectomy and gastric ;interposition between Chinese and Canadian population
10.3760/cma.j.issn.1671-0274.2015.09.006
- VernacularTitle:不同人种食管切除术后残余食管黏膜反流性损伤的比较研究
- Author:
Yong YUAN
1
;
Andre DURANCEAU
;
Longqi CHEN
;
Yang HU
;
Yongfan ZHAO
Author Information
1. 四川大学华西医院胸外科
- Keywords:
Esophagus;
Mucosal damage;
Esophagogastrostomy;
Gastroesophageal reflux
- From:
Chinese Journal of Gastrointestinal Surgery
2015;(9):871-874
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the difference of mucosal damage in the remnant esophagus with similar postoperative reflux after esophagectomy and gastric interposition between Chinese and Canadian population. Methods A prospective 1∶1 paired study based on the same surgical approach was performed in Medical Centre of University of Montreal and West China Hospital of Sichuan University during the period from September 2010 to October 2013. The patients were followed up and evaluated by reflux symptom scoring, endoscopic assessment of mucosal damage, pathologic examination of biopsies and proliferation index test of esophageal epithelium. Results Eighteen Han Chinese and 18 Caucasian Canadian patients with esophagectomy and gastric interposition were included in this study , with a follow-up period of 45 (28-67) months. There were no significant differences between the two groups in the incidence of postoperative reflux symptom, reflux symptom scoring, histological reflux esophagitis, erosion or stricture of remnant esophagus (all P>0.05). However, the incidence of mucosal metaplasia [44.4%(8/18) versus 11.1%(2/18), P=0.026], quantitative MUSE scoring [1.5(1.0-2.0) versus 1.0 (0-2.0), P=0.042] and proliferation index [0.40 (0.30-0.45) versus 0.35 (0.30-0.50), P=0.038] of esophageal epithelium were significantly higher in Canadian patients than those in Chinese patients. Conclusion Under similar reflux situation, esophageal mucosa of Canadian population is more sensitive to the gastroesophageal reflux damage compared with Chinese population , resulting in more severe reflux damage of remnant esophagus in Canadian patients.
