title: [Can esophagogastric anastomosis prevent gastroesophageal reflux].
abstract: OBJECTIVE
  To investigate the possible anti-reflux function of esophagogastric anastomosis in the patients after receiving resection of cardiac cancer.
  
  
  METHODS
  One hundred and ninety-two patients were studied by video-assisted gastroscopy, manometry, 24-h pH esophageal monitoring, radioscintigraphy and scanning electron microscopy.
  
  
  RESULTS
  Abnormalities were found in 90.2% of patients through endoscopy. Resting pressure in esophageal body was higher than that in normal controls, and in the stomach, lower. Twenty-four hour pH monitoring demonstrated that gastroesophageal reflux (GER) did not occur when the patients slept in semi-reclining position, and occurred in all patients when slept in supine position. Scintigraphic study showed that 2/3 of the patients had reflux, occurrence of which was not affected by the length of postoperative period. Scanning electron microscopic examination showed that degeneration, exfoliation of esophageal mucosal epithelial cell, and derangement of micro-fold and inflammatory oedema of cytomembrane may be directly caused by reflux.
  
  
  CONCLUSIONS
  GER exists in the majority of the patients after esophagogastrectomy and esophagogastrostomy for cardiac cancer. The occurrence of GER is not affected by the length of postoperative period. Some detecting methods fail to show the existence of GER, and 24-h pH monitoring is the most reliable method for detecting GER. Sleep in semireclining position is an effective method of preventing GER in postoperative patients.
authors.affiliation: Depatment of Thoracic Surgery, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011.
authors.forename: Q
authors.initials: Q
authors.lastname: Wang
authors.forename: J
authors.initials: J
authors.lastname: Liu
authors.forename: X
authors.initials: X
authors.lastname: Zhao
authors.forename: J
authors.initials: J
authors.lastname: Lei
authors.forename: Q
authors.initials: Q
authors.lastname: Cong
authors.forename: W
authors.initials: W
authors.lastname: Li
authors.forename: B
authors.initials: B
authors.lastname: Li
authors.forename: F
authors.initials: F
authors.lastname: Wang
authors.forename: F
authors.initials: F
authors.lastname: Cao
authors.forename: X
authors.initials: X
authors.lastname: Zhang
authors.forename: H
authors.initials: H
authors.lastname: Zhang
authors.forename: H
authors.initials: H
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects; D002299:Cardia / Q000601:surgery; D050782:Esophageal pH Monitoring; D004947:Esophagus / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005764:Gastroesophageal Reflux / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control*; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D008991:Monitoring, Physiologic; D012680:Sensitivity and Specificity; D013270:Stomach / Q000601:surgery*; D013274:Stomach Neoplasms / Q000601:surgery