title: Manometric study in patients with or without preserved lower esophageal sphincter 2 years or more after total gastrectomy reconstructed by Roux-en-Y for gastric cancer.
abstract: OBJECTIVE
  Physiological assessments in patients with or without preserved lower esophageal sphincter (LES) after total gastrectomy reconstructed by Roux-en-Y (TGRY) are still inconclusive. This study aims to clarify the significance of LES functions in patients, especially prevention of alkali reflux esophagitis (ARE) after TGRY for gastric cancer.
  
  
  METHODS
  Forty-eight patients after TGRY were divided into 2 groups. Group A: 20 patients without preserved LES and group B: 28 patients with preserved LES, and compared with 20 control subjects. The mean follow-up time from operation of TGRY was 27.1 months. Postoperative interview and endoscopic findings for ARE were conducted and esophageal manometry was performed on all patients in order to assess length of LES (LLES; cm) and maximum LES pressure (MLESP; mmHg).
  
  
  RESULTS
  Both symptoms and endoscopic findings for ARE in group A were significantly higher than those in group B. The LLES in group A was significantly shorter than that in groups B and C. The MLESP in group A was significantly lower than in groups B and C.
  
  
  CONCLUSIONS
  ARE after TGRY is due to an impairment of LES functions. Preservation of the LES may be necessary to prevent ARE after TGRY.
authors: Department of Surgery, Nippon Dental University School of Life Dentistry, Tokyo, Japan. rtomita-ndus@mvg.biglobe.ne.jp
authors: Ryouichi
authors: R
authors: Tomita
authors: Kenichi
authors: K
authors: Sakurai
authors: Shigeru
authors: S
authors: Fujisaki
authors: Masahiko
authors: M
authors: Shibata
mesh_terms: D000328:Adult; D000368:Aged; D000713:Anastomosis, Roux-en-Y / Q000009:adverse effects; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D016099:Endoscopy, Gastrointestinal; D049630:Esophageal Sphincter, Lower / Q000503:physiopathology / Q000601:surgery*; D004942:Esophagitis, Peptic / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D059351:Organ Sparing Treatments / Q000009:adverse effects; D011237:Predictive Value of Tests; D011312:Pressure; D019651:Plastic Surgery Procedures / Q000009:adverse effects; D013274:Stomach Neoplasms / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome