Reflux Esophagitis Following a Loop Esophagojejunostomy with a Braun Anastomosis after a Total Gastrectomy for Gastric Cancer.
- Author:
Sang Bo YOON
1
;
Seung Kyu JEONG
;
Kun Pil CHOI
Author Information
1. Department of General Surgery, Seoul Adventist Hospital.
- Publication Type:Original Article
- Keywords:
Total gastrectomy;
Gastric cancer;
Reflux esophagitis
- MeSH:
Anastomosis, Roux-en-Y;
Anastomotic Leak;
Cardia;
Cause of Death;
Classification;
Esophagitis, Peptic*;
Female;
Gastrectomy*;
Humans;
Male;
Mortality;
Pneumonia;
Retrospective Studies;
Seoul;
Sex Ratio;
Stomach Neoplasms*
- From:Journal of the Korean Surgical Society
1998;55(5):678-684
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUNDS: Reflux esophagitis has been known to be a frequent complication after a total gastrectomy. Reflux esophagitis is very annoying to the patients, so various types of reconstructions has been introduced to eliminate this complication. METHODS: This study is a retrospective clinical analysis of 34 patients with gastric cancer who were treated with a total gastrectomy from January 1989 to December 1997 at the Department of Surgery, Seoul Adventist Hospital. RESULTS: During 9 years, the operation was performed on 194 patients with gastric cancer, amomg which 34 (17.3%) were total gastrectomies. The peak age was in the 5th and the 6th decades (58.8%), and the sex ratio of males to females was 1.6:1. The sites of the stomach cancer were the cardia (C) in 10 cases (29.4%), the body (M) in 19 cases (55.9%), and the cardia and body in 5 cases (14.7%). The TNM classification was stage I in 15.6% of the cases, stage II in 15.6% of the cases, stage III in 62.5% of the cases, and stage IV in 6.3% of the cases. Three methods of alimentary tract reconstruction were used:a loop esophagojejunostomy with a Braun anastomosis (27), a Roux-en-Y esophagojejunostomy (6), and an uncut Roux procedure (1). The reflux esophagitis rates for patients treated with a loop esophagojejunostomy with a Braun anastomosis and for patients treated with a Roux-en-Y esophagojejunostomy were 25.9% and 16.7%, respectively. The perioperative mortality was 5.8%, and the causes of death were pneumonia and anastomotic leakage. The most common recurrent site was the anastomotic site. CONCLUSIONS: Reflux esophagitis developed more often after a loop esophagojejunostomy with a Braun anastomosis than after a Roux-en-Y anastomosis. This finding was not significant statistically. Thus, further study of more cases is needed.
