title: [Functional study of the remnant esophagus and intrathoracic stomach in patients who underwent esophagectomy for cancer].
abstract: 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.
authors.affiliation: Department of Thoracic Surgery, Fourth Hospital, Hebei Medical University, Shijiazhuang 050011, China.
authors.forename: Jun-feng
authors.initials: JF
authors.lastname: Liu
authors.forename: Jin-dong
authors.initials: JD
authors.lastname: Wang
authors.forename: Shao-wei
authors.initials: SW
authors.lastname: Zhang
authors.forename: Zi-qiang
authors.initials: ZQ
authors.lastname: Tian
authors.forename: Qi-zhang
authors.initials: QZ
authors.lastname: Wang
authors.forename: Bao-qing
authors.initials: BQ
authors.lastname: Li
authors.forename: Fu-shun
authors.initials: FS
authors.lastname: Wang
authors.forename: Fu-min
authors.initials: FM
authors.lastname: Cao
authors.forename: Yue-feng
authors.initials: YF
authors.lastname: Zhang
authors.forename: Yong
authors.initials: Y
authors.lastname: Li
mesh_terms: 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