[Functional study of the remnant esophagus and intrathoracic stomach in patients who underwent esophagectomy for cancer].
OBJECTIVE
To investigate pathophysiological changes of the remnant esophagus and gastric cardia in patients who underwent esophagectomy for cancer, and to provide objective evidences for the improvement of the postoperative quality of life.


METHODS
The function of the remnant esophagus and intrathoracic stomach in patients who underwent esophagectomy for cancer were assessed objectively. The methods that we used were gastric scintigraphy, esophageal manometry, 24-hour esophageal pH monitoring, electronic gastroscopy, videofluoroscopy, and DeMeester scoring system for the assessment of heartburn. Findings were recorded and compared with normal controls.


RESULTS
After esophagectomy for cancer, the emptying of intrathoracic stomach was delayed (t = 7.105, P < 0.01) and improved over time, but could not reach normal one year after surgery (t = 2.9, P = 0.016). In patients who had undergone esophagectomy for cancer, the contracting pressure of the upper esophageal sphincter and resting pressure of the remnant esophagus were higher than that in normal controls (t = 2.275, P = 0.03; t = 2.16, P = 0.039 respectively). 89.7% of patients who had undergone esophagectomy had gastroesophageal reflux measured with 24-hour pH monitoring. The extent of reflux was less severe when patients were in a semi-reclining position than in a prostration position (t = 3.074, P = 0.005).


CONCLUSIONS
After esophagectomy for cancer, delayed emptying of the intrathoracic stomach is improved gradually over time, but it is inaccessible to normal level. Gastroesophageal reflux extensively exists in patients who underwent esophagectomy for cancer, but it can be lessened by taking semi-reclining position.
Liu
Jun-feng
JF
Department of Thoracic Surgery, Fourth Hospital, Hebei Medical University, Shijiazhuang 050011, China.
Wang
Jin-dong
JD
Zhang
Shao-wei
SW
Tian
Zi-qiang
ZQ
Wang
Qi-zhang
QZ
Li
Bao-qing
BQ
Wang
Fu-shun
FS
Cao
Fu-min
FM
Zhang
Yue-feng
YF
Li
Yong
Y
D000328:Adult; D000368:Aged; D002299:Cardia; D004938:Esophageal Neoplasms / Q000503:physiopathology / Q000601:surgery; D016629:Esophagectomy; D004947:Esophagus / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D013270:Stomach / Q000503:physiopathology*; D013274:Stomach Neoplasms / Q000503:physiopathology / Q000601:surgery