title: Reducing the gastroesophageal reflux with lip-type reinforcement technique during intrathoracic esophagogastrostomy.
abstract: OBJECTIVE
  Gastroesophageal reflux is a significant problem after esophagogastrostomy, and impact considerably upon the quality of patients' lives. Aims of this study were to evaluate the operative effects in prevention of reflux with lip-type reinforcement during intrathoracic esophagogastric anastomosis.
  
  
  METHODS
  From January 2005 to December 2009, 216 patients received circular stapled esophagogastrostomy with lip-type reinforcement (LR group), and 69 patients with standard reinforcement (SR group) at our hospital. Major observation parameters were symptoms of reflux and dysphagia.
  
  
  RESULTS
  No differences in clinicopathologic characteristics between two groups, in addition to the incidence of anastomotic leakage was less in LR group (p = 0.039). Grade of dysphagia and anastomotic stricture also were not different between two groups (p >0.05). Symptoms of reflux were better controlled in patients with lip-type reinforcement than standard reinforcement (p <0.001). In LR group, 71.3% were asymptomatic with respect to reflux compared to 29.7% in SR group (p <0.001). The incidence of reflux esophagitis was 23.5% in LR group and 58.3% in SR group (p <0.001). There was a significant correlation between reflux symptoms and endoscopic findings of reflux esophagitis (p = 0.001).
  
  
  CONCLUSIONS
  Lip-type reinforcement is simple to perform, and effective in controlling gastroesophageal reflux and decreasing anastomotic leakage in majority of patients after esophagogastrostomy.
authors.forename: Bin
authors.initials: B
authors.lastname: Li
authors.forename: Yu-Min
authors.initials: YM
authors.lastname: Li
authors.forename: Jian-Hua
authors.initials: JH
authors.lastname: Zhang
authors.forename: Cheng
authors.initials: C
authors.lastname: Wang
authors.forename: Yun-Feng
authors.initials: YF
authors.lastname: Su
authors.forename: Yun-Jiu
authors.initials: YJ
authors.lastname: Gou
authors.forename: Zhi-Qian
authors.initials: ZQ
authors.lastname: Wang
authors.forename: Tie-Niu
authors.initials: TN
authors.lastname: Song
authors.forename: Jian-Bao
authors.initials: JB
authors.lastname: Yang
mesh_terms: D000368:Aged; D057868:Anastomotic Leak / Q000209:etiology / Q000517:prevention & control; D016009:Chi-Square Distribution; D016099:Endoscopy, Gastrointestinal; D004938:Esophageal Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D004942:Esophagitis, Peptic / Q000209:etiology / Q000517:prevention & control; D004946:Esophagostomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D005260:Female; D018662:Fundoplication; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D005774:Gastrostomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D017792:Surgical Stapling / Q000009:adverse effects / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome