Document Detail

Esophageal manometric changes and gastroesophageal reflux symptoms after distal gastrectomy for gastric cancer.
MedLine Citation:
PMID:  15783057     Owner:  NLM     Status:  MEDLINE    
BACKGROUND/AIMS: Gastroesophageal reflux is known to be a common complication after gastrectomy. However, its mechanism is not completely understood. We investigated the effects of distal gastrectomy for gastric cancer on the lower esophageal sphincter (LES) and esophageal motility. METHODOLOGY: In 18 patients who underwent distal gastrectomy reconstructed with Billroth I method for gastric cancer, esophageal motility and LES function were evaluated by means of a low-compliance manometric system. The LES pressure was determined by a rapid pull-through technique. Endoscopy before and after operation determined presence or absence of esophagitis and hiatus hernia. RESULTS: No significant differences were observed in esophageal contractile amplitudes before and after distal gastrectomy. After distal gastrectomy, five patients had reflux symptoms of heartburn and regurgitation; 11 had none. Endoscopy revealed esophagitis after distal gastrectomy in two patients with reflux symptoms and one patient without reflux symptoms. The LES pressure in patients with reflux symptoms decreased significantly after distal gastrectomy (before gastrectomy: 26.1 +/- 1.1 mmHg, after distal gastrectomy: 15.3 +/- 3.5 mmHg, p<0.05). There was no significant change in patients without reflux symptoms. CONCLUSIONS: This study demonstrated that LES pressure after distal gastrectomy in patients with reflux symptoms was significantly lower than that before gastrectomy. This result suggested that LES pressure decrease plays an important role in development of gastroesophageal reflux after distal gastrectomy reconstruction with the Billroth I method.
Norihiro Haga; Erito Mochiki; Toshihiro Nakabayashi; Tomoaki Suzuki; Takayuki Asao; Hiroyuki Kuwano
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Hepato-gastroenterology     Volume:  52     ISSN:  0172-6390     ISO Abbreviation:  Hepatogastroenterology     Publication Date:    2005 Jan-Feb
Date Detail:
Created Date:  2005-03-23     Completed Date:  2005-07-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8007849     Medline TA:  Hepatogastroenterology     Country:  Greece    
Other Details:
Languages:  eng     Pagination:  310-3     Citation Subset:  IM    
Department of Surgery, Gunma Cancer Center, Ota, Japan.
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MeSH Terms
Esophageal Sphincter, Lower / physiopathology*
Follow-Up Studies
Gastrectomy / adverse effects*
Gastroesophageal Reflux / etiology*,  physiopathology
Gastrointestinal Motility / physiology*
Lymph Node Excision
Middle Aged
Stomach Neoplasms / physiopathology,  surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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