Clinical characteristics of esophageal reflux after total gastrectomy
10.3760/cma.j.cn113855-20201030-00829
- VernacularTitle:全胃切除术后食管反流的临床特点分析
- Author:
Zhiyuan ZHENG
;
Yancheng CUI
;
Jing ZHANG
;
Chao SHEN
;
Yushi ZHOU
;
Xin LIU
;
Yingjiang YE
;
Qiwei XIE
;
Mujun YIN
;
Xiaodong YANG
;
Kewei JIANG
;
Zhidong GAO
;
Zhifeng WANG
;
Lili ZHAO
;
Shan WANG
;
Bin LIANG
- From:
Chinese Journal of General Surgery
2021;36(4):267-271
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To observe the clinical characteristics of esophageal reflux after total gastrectomy (ERATG), and to explore the mechanism of occurrence.Methods:Fourteen gastric cancer patients who underwent total gastrectomy were prospectively enrolled in this study. The postoperative symptoms were observed and recorded and 24 h MII-pH with pH monitoring was performed to investigate the characteristics of postoperative reflux.Results:After total gastrectomy patients were with different degrees of ERATG as heartburn, appetite loss, chest tightness and belching. The overall nature of ERATG is mainly weak acid, with a pH between 4 and 7. ERATG involved esophageal-jejunal anastomosis and a length of esophagus 7 cm above the anastomosis. Patients with typical reflux symptoms had a lower pH minimum in the upright position than those without typical symptoms[(4.76±0.71) vs.(5.68±0.37), t=2.866, P<0.05]. Patients with typical reflux symptoms had a higher frequency of reflux of mixed liquid and liquid-air reflux than those without typical symptoms[liquid(31.25±29.76) vs.(4.50±9.14), t=0.011, P<0.05; liquid-air(19.50±12.99) vs.(2.00±2.61), t=0.004, P<0.05]. Conclusion:ERATG is mainly a upward reflux of weakly acidic gas, with typical symptoms of heartburn, appetite loss, chest tightness and belching. Patients with typical symptoms usually have lower pH in the upright position.
