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Evaluation of “Alkaline” reflux esophagitis after total gastrectomy in Henley and Roux-en-Y reconstructive procedures

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Abstract

The occurrence of reflux esophagitis was evaluated in 2 groups of patients who had undergone total gastrectomy. In group 1 (4 patients) gastrointestinal continuity was restored by Henley's method of esophagojejunoduodenostomy, and in group 2 (4 patients) reconstruction was accomplished by Roux-en-Y esophagojejunostomy. Cineradiography, intraesophageal pH measurements, esophagoscopy, esophageal biopsies, and study of intestinal motility were performed. Alkaline esophageal reflux was observed only in group 2, and a high frequency of esophageal symptoms and esophagitis were found in this group. These results can be correlated with the different motor behavior in the jejunum used for reconstruction, occurring in the 2 groups of patients.

Résumé

L'oesophagite par reflux après gastrectomie totale a été comparée dans, 2 groupes d'opérés dont la continuité digestive avait été rétablie, soit par transplant jéjunal selon Henley (groupe 1∶ 4 malades), soit par oesojéjunostomie en Y (groupe 2∶ 4 malades). Tous les opérés ont été étudiés par cinéradiographie, mesure du pH oesophagien, oesophagoscopie, biopsies de l'oesophage et enregistrement de la motilité intestinale. C'est dans le groupe 2 seulement que nous avons observé du reflux alcalin dans l'oesophage et une fréquence élevée de symptomes oesophagiens et d'oesophagites. Ces résultats concordent avec les différences d'activité motrice de l'anse jéjunale anastomosée à l'oesophage.

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Authors and Affiliations

  1. Istituto di 2∘ Patologia Chirurgica, Cattedza di Gastroenterologia, University of Rome, Italy

    Francesco Tonelli M.D., Enrico Corazziari M.D. & Francesco Spinelli M.D.

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  1. Francesco Tonelli M.D.
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  2. Enrico Corazziari M.D.
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  3. Francesco Spinelli M.D.
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Tonelli, F., Corazziari, E. & Spinelli, F. Evaluation of “Alkaline” reflux esophagitis after total gastrectomy in Henley and Roux-en-Y reconstructive procedures. World J. Surg. 2, 233–237 (1978). https://doi.org/10.1007/BF01553561

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