Ulcer in the gastric tube for esophageal replacement: a comparison of 12 esophageal cancer patients with or without postoperative radiotherapy.
OBJECTIVE
Ulcer in the gastric tube for esophageal replacement, which was caused by peptic factors or postoperative radiotherapy (Rx), are occasionally reported. The aim of this study was to clarify the clinicopathologic features of the ulcers in the gastric tube.


METHODS
In 62 patients with a reconstructed gastric tube, after esophagectomy for esophageal cancer, esophagogastroduodenoscopy was performed. Ulcers of the gastric tube were detected in 12 patients: six with postoperative Rx and six without Rx. The 12 patients with gastric tube ulcers (GU-group) were reviewed and compared to the remaining 50 patients without ulcers of the gastric tube (Control-group). Clinicopathologic features of gastric tube ulcers were compared between the patients with and without Rx.


RESULTS
There was no difference in any parameter between the patients of the GU- and Control-groups. Comparing the patients of the GU-group with and without Rx, the ulcers of the gastric tube in the patients without Rx were frequently located in the lower part of the gastric tube (P = 0.067), detected in a later period after surgery (P = 0.055), associated with cervical esophagitis (P = 0.03), and less associated with gastritis (P = 0.03). In three patients of the GU-group without Rx, Helicobacter pylori was detected in the gastric tube. Two of the three patients had a history of peptic ulcers before surgery, and had recurrence of the gastric tube ulcers.


CONCLUSIONS
Gastric tube ulcers without postoperative Rx may have different characteristics compared to those induced by Rx.
Koide
N
N
Second Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan. surgery2@hsp.md.shinshu-u.ac.jp
Hiraguri
M
M
Nishio
A
A
Hanazaki
K
K
Adachi
W
W
Shikama
N
N
Oguchi
M
M
Maezawa
T
T
Amano
J
J
D016145:Endoscopy, Digestive System / Q000009:adverse effects; D004938:Esophageal Neoplasms / Q000150:complications* / Q000532:radiotherapy; D016629:Esophagectomy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000209:etiology* / Q000532:radiotherapy; D012189:Retrospective Studies; D016896:Treatment Outcome