title: Impact of gastropyloric motor activity on the genesis of reflux esophagitis after an esophagectomy with gastric tube reconstruction.
abstract: BACKGROUND
  Reflux esophagitis is a significant problem in patients after an esophagectomy with gastric tube reconstruction. The pathogenesis of reflux esophagitis is not fully understood. The aim of the present study was to evaluate whether gastropyloric motility influences the pathogenesis of reflux esophagitis after an esophagectomy.
  
  
  METHODS
  Thirty esophagectomized patients were assessed by endoscopy and manometry. The patients were classified into 3 groups according to the postoperative period as follows: Group 1 (less than 12 months), group 2 (12 to 24 months), and group 3 (more than 24 months). Gastropyloric motor activity was quantified by calculating the motility index, which is equivalent to the area under the contractile waves.
  
  
  RESULTS
  Reflux esophagitis was observed in 80% of group 1, 80% of group 2, and 30% of group 3. The severity of reflux esophagitis decreased with time. Contractions of the gastric body were not observed in any of the patients. The antral motility index in group 3 was significantly greater than that in groups 1 and 2. The pyloric motility index progressively increased. The severity of reflux esophagitis is significantly associated with gastropyloric motor activity.
  
  
  CONCLUSIONS
  The severity of reflux esophagitis decreases with time, coupled with recovery of antropyloric motor activity. Gastropyloric motor activity plays an important role in the genesis of reflux esophagitis after an esophagectomy.
authors.affiliation: Department of Surgery, Gunma Prefectural Cardiovascular Center, Maebashi, Japan; Department of General Surgical Science, Gunma University, Graduate School of Medicine, Maebashi, Japan. Electronic address: tnakaba@showa.gunma-u.ac.jp.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Nakabayashi
authors.forename: Erito
authors.initials: E
authors.lastname: Mochiki
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Kamiyama
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kato
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kuwano
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000601:surgery; D004938:Esophageal Neoplasms / Q000601:surgery; D016629:Esophagectomy / Q000009:adverse effects* / Q000379:methods*; D004942:Esophagitis, Peptic / Q000209:etiology*; D005260:Female; D005769:Gastrointestinal Motility; D006801:Humans; D008297:Male; D008875:Middle Aged; D011706:Pyloric Antrum / Q000503:physiopathology*; D012189:Retrospective Studies; D013270:Stomach / Q000601:surgery*
keywords: 8