Clinical analysis of reflux esophagitis following esophagectomy with gastric tube reconstruction.
BACKGROUND
Recently, the rate of postoperative long-term survival has increased in cases of esophageal cancer. We report on our analysis of postoperative reflux esophagitis (RE) at Tokai University.


METHODS
We enrolled 48 patients who underwent gastric tube reconstruction after esophagectomy. The diagnosis of RE was confirmed by endoscopy.


RESULTS
Of the 48 patients, 28 (58.3%) were found to have RE. Among the 28 patients with RE, only four (14.3%) reported symptoms. The distribution of the severity of RE according to the Los Angeles classification in the patients was as follows: grade M, 1 (3.6%); grade A, 2 (7.1%); grade B, 6 (21.4%); grade C, 17 (60.7%); and grade D, 2 cases (7.1%). Barrett's epithelium was detected in 9 of the 28 patients (31%) with RE and in 3 of the 20 (15%) patients with no evidence of RE.


CONCLUSIONS
To detect the presence of RE as well as monitor for recurrence and development of metachronous cancer, we consider it important to perform endoscopy regularly over the long term. As Barrett's epithelium is frequently encountered, care should be exercised to detect the specialized columnar epithelium showing dysplastic changes.
Yamamoto
Soichiro
S
Department of Surgery, Tokai University School of Medicine, Bohseidai, Isehara, Kanagawa 259-1193, Japan.
Makuuchi
Hiroyasu
H
Shimada
Hideo
H
Chino
Osamu
O
Nishi
Takayuki
T
Kise
Yoshifumi
Y
Kenmochi
Takahiro
T
Hara
Tadashi
T
D000368:Aged; D001471:Barrett Esophagus / Q000453:epidemiology; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy; D004942:Esophagitis, Peptic / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000503:physiopathology; D013270:Stomach / Q000637:transplantation