Abstract
Background
Recently, the rate of postoperative long-term survival has increased in cases of esophageal cancer. We report on our analysis of postoperative reflux esophagitis (RE) at Tokai University.
Methods
We enrolled 48 patients who underwent gastric tube reconstruction after esophagectomy. The diagnosis of RE was confirmed by endoscopy.
Results
Of the 48 patients, 28 (58.3%) were found to have RE. Among the 28 patients with RE, only four (14.3%) reported symptoms. The distribution of the severity of RE according to the Los Angeles classification in the patients was as follows: grade M, 1 (3.6%); grade A, 2 (7.1%); grade B, 6 (21.4%); grade C, 17 (60.7%); and grade D, 2 cases (7.1%). Barrett's epithelium was detected in 9 of the 28 patients (31%) with RE and in 3 of the 20 (15%) patients with no evidence of RE.
Conclusions
To detect the presence of RE as well as monitor for recurrence and development of metachronous cancer, we consider it important to perform endoscopy regularly over the long term. As Barrett's epithelium is frequently encountered, care should be exercised to detect the specialized columnar epithelium showing dysplastic changes.
Similar content being viewed by others
References
AJ McLarty C Deschamps VF Trastek MS Allen PC Pairolero WS Harmsen (1997) ArticleTitleEsophageal resection for cancer of the esophagus: long-term function and quality of life Ann Thorac Surg 63 1568–72 Occurrence Handle9205149 Occurrence Handle10.1016/S0003-4975(97)00125-2 Occurrence Handle1:STN:280:ByiA2cbhsVE%3D
J Lagergren R Bergstrom A Lindgren O Nyren (1999) ArticleTitleSymptomatic gastroesophageal reflux as a risk factor for esophageal adenocarcinoma N Engl J Med 340 825–31 Occurrence Handle10080844 Occurrence Handle10.1056/NEJM199903183401101 Occurrence Handle1:STN:280:DyaK1M7msFeitw%3D%3D
L Bonavina M Anselmino A Ruol R Bardini N Borsato A Peracchia (1992) ArticleTitleFunctional evaluation of the intrathoracic stomach as an oesophageal substitute Br J Surg 79 529–32 Occurrence Handle1611444 Occurrence Handle10.1002/bjs.1800790618 Occurrence Handle1:STN:280:By2A3crot1M%3D
J Domergue M Veyrac S Huin-Yan P Rouanet H Collet H Michel et al. (1990) ArticleTitlepH monitoring for 24 hours of gastroesophageal reflux and gastric function after intrathoracic gastroplasty after esophagectomy Surg Gynecol Obstet 171 107–10 Occurrence Handle2382185 Occurrence Handle1:STN:280:By%2BA2c7ovVM%3D
C Gutschow JM Collard R Romagnoli M Salizzoni A Holscher (2001) ArticleTitleDenervated stomach as an esophageal substitute recovers intraluminal acidity with time Ann Surg 233 509–14 Occurrence Handle11303132 Occurrence Handle10.1097/00000658-200104000-00005 Occurrence Handle1:STN:280:DC%2BD3M3kvVajsw%3D%3D
N Okada O Nishimura T Sakurai S Tsuchihashi M Juhri (1986) ArticleTitleGastric functions in patients with the intrathoracic stomach after esophageal surgery Ann Surg 204 114–21 Occurrence Handle3741002 Occurrence Handle10.1097/00000658-198608000-00003 Occurrence Handle1:STN:280:BimB1MvnvFc%3D
M Hashimoto M Imamura Y Shimada Y Shirakata K Takeuchi (1995) ArticleTitleTwenty-four hour monitoring of pH in the gastric tube replacing the resected esophagus J Am Coll Surg 180 666–72 Occurrence Handle7773479 Occurrence Handle1:STN:280:ByqB1M7ltlE%3D
N Yuasa E Sasaki T Ikeyama H Miyake Y Nimura (2005) ArticleTitleAcid and duodenogastroesophageal reflux after esophagectomy with gastric tube reconstruction Am J Gastroenterol 100 1021–7 Occurrence Handle15842574 Occurrence Handle10.1111/j.1572-0241.2005.41109.x
JM O'Riordan ON Tucker PJ Byrne GS McDonald N Ravi PW Keeling et al. (2004) ArticleTitleFactors influencing the development of Barrett's epithelium in the esophageal remnant postesophagectomy Am J Gastroenterol 99 205–11 Occurrence Handle15046206 Occurrence Handle10.1111/j.1572-0241.2004.04057.x
S Kaseno (1999) ArticleTitleClinical study of the reflux esophagitis following esophageal reconstruction using the gastric roll through the posterior mediastinum after radical esophagectomy for esophageal cancer J Jpn Surg Assoc 60 306–15
S Shibuya S Fukudo R Shineha S Miyazaki G Miyata K Sugawara et al. (2003) ArticleTitleHigh incidence of reflux esophagitis observed by routine endoscopic examination after gastric pull-up esophagectomy World J Surg 27 580–3 Occurrence Handle12715227 Occurrence Handle10.1007/s00268-003-6780-7
SJ Spechler AH Robbins HB Rubins ME Vincent T Heeren WG Doos et al. (1984) ArticleTitleAdenocarcinoma and Barrett's esophagus. An overrated risk? Gastroenterology 87 927–33 Occurrence Handle6468881 Occurrence Handle1:STN:280:BiuB1cnmt1Y%3D
M Savary G Miller (1978) The esophagus AG Gassmann (Eds) Handbook and atlas of endoscopy Solothurn Switzerland 135–9
NS Mann MF Tsai PK Nair (1989) ArticleTitleBarrett's esophagus in patients with symptomatic reflux esophagitis Am J Gastroenterol 84 1494–6 Occurrence Handle2596449 Occurrence Handle1:STN:280:By%2BD1cnntFc%3D
C Winters SuffixJr TJ Spurling SJ Chobanian DJ Curtis RL Esposito JF Hacker Suffix3rd et al. (1987) ArticleTitleBarrett's esophagus. A prevalent, occult complication of gastroesophageal reflux disease Gastroenterology 92 118–24 Occurrence Handle3781178
D Franchimont A Covas C Brasseur JL Laethem I El-Nakadi J Deviere (2003) ArticleTitleNewly developed Barrett's esophagus after subtotal esophagectomy Endoscopy 35 850–3 Occurrence Handle14551864 Occurrence Handle10.1055/s-2003-42623 Occurrence Handle1:STN:280:DC%2BD3svnsVGnuw%3D%3D
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Yamamoto, S., Makuuchi, H., Shimada, H. et al. Clinical analysis of reflux esophagitis following esophagectomy with gastric tube reconstruction. J Gastroenterol 42, 342–345 (2007). https://doi.org/10.1007/s00535-007-2011-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00535-007-2011-6