Postoperative reflux esophagitis in laparoscopic distal gastrectomy with Billroth-I reconstruction for gastric cancer: Nutritional effect and preoperative risk factors
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作者:
Tsuchiya, Hiroshi
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Gifu Univ, Grad Sch Med, Grad Sch Med, Gifu, JapanGifu Univ, Grad Sch Med, Grad Sch Med, Gifu, Japan
Tsuchiya, Hiroshi
[1
]
Yasufuku, Itaru
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Gifu Univ, Grad Sch Med, Grad Sch Med, Gifu, JapanGifu Univ, Grad Sch Med, Grad Sch Med, Gifu, Japan
Yasufuku, Itaru
[1
]
Fukada, Masahiro
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Gifu Univ, Grad Sch Med, Grad Sch Med, Gifu, JapanGifu Univ, Grad Sch Med, Grad Sch Med, Gifu, Japan
Fukada, Masahiro
[1
]
Higashi, Toshiya
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Gifu Univ, Grad Sch Med, Grad Sch Med, Gifu, JapanGifu Univ, Grad Sch Med, Grad Sch Med, Gifu, Japan
Higashi, Toshiya
[1
]
Asai, Ryuichi
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Gifu Univ, Grad Sch Med, Grad Sch Med, Gifu, JapanGifu Univ, Grad Sch Med, Grad Sch Med, Gifu, Japan
Asai, Ryuichi
[1
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Sato, Yuta
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Gifu Univ, Grad Sch Med, Grad Sch Med, Gifu, JapanGifu Univ, Grad Sch Med, Grad Sch Med, Gifu, Japan
Sato, Yuta
[1
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Tajima, Jessi Yu
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Gifu Univ, Grad Sch Med, Grad Sch Med, Gifu, JapanGifu Univ, Grad Sch Med, Grad Sch Med, Gifu, Japan
Tajima, Jessi Yu
[1
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Kiyama, Shigeru
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Gifu Univ, Grad Sch Med, Grad Sch Med, Gifu, JapanGifu Univ, Grad Sch Med, Grad Sch Med, Gifu, Japan
Kiyama, Shigeru
[1
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Tanaka, Yoshihiro
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Gifu Univ, Grad Sch Med, Grad Sch Med, Gifu, JapanGifu Univ, Grad Sch Med, Grad Sch Med, Gifu, Japan
Tanaka, Yoshihiro
[1
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Okumura, Naoki
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Gifu Univ, Grad Sch Med, Grad Sch Med, Gifu, JapanGifu Univ, Grad Sch Med, Grad Sch Med, Gifu, Japan
Okumura, Naoki
[1
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Murase, Katsutoshi
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Gifu Univ, Grad Sch Med, Grad Sch Med, Gifu, JapanGifu Univ, Grad Sch Med, Grad Sch Med, Gifu, Japan
Murase, Katsutoshi
[1
]
Takahashi, Takao
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Gifu Univ, Grad Sch Med, Grad Sch Med, Gifu, JapanGifu Univ, Grad Sch Med, Grad Sch Med, Gifu, Japan
Takahashi, Takao
[1
]
Matsuhashi, Nobuhisa
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Gifu Univ, Grad Sch Med, Grad Sch Med, Gifu, Japan
Gifu Univ, Dept Gastroenterol & Pediat Surg, Grad Sch Med, 1-1 Yanagit, Gifu, Gifu 5011194, JapanGifu Univ, Grad Sch Med, Grad Sch Med, Gifu, Japan
Matsuhashi, Nobuhisa
[1
,2
]
机构:
[1] Gifu Univ, Grad Sch Med, Grad Sch Med, Gifu, Japan
[2] Gifu Univ, Dept Gastroenterol & Pediat Surg, Grad Sch Med, 1-1 Yanagit, Gifu, Gifu 5011194, Japan
Introduction: Postoperative reflux esophagitis represents a major complication of laparoscopic distal gastrectomy (LDG) with Billroth-I reconstruction (LDGBI). This study aimed to evaluate the nutritional effect and preoperative risk factors of postoperative reflux esophagitis in patients undergoing LDGBI for gastric cancer. Methods: We retrospectively analyzed data of patients with (reflux [+]) and without (reflux [-]) postoperative reflux esophagitis who underwent LDGBI in our institution. Patient backgrounds, surgical outcomes, and perioperative nutritional status were compared. Preoperative risk factors for postoperative reflux esophagitis were also evaluated. Results: Between January 2009 and December 2016, 242 patients underwent LDG for gastric cancer. Of these, 218 underwent Billroth-I reconstruction. Seventy-three patients were excluded because of nutritional or oncological reasons. Finally, 23 patients were enrolled as the reflux (+) group and 122 as the reflux (-) group. Although the preoperative/postoperative bodyweight ratio and albumin and hemoglobin values plateaued beyond 6 months postoperatively in the reflux (-) group, these parameters continued to decrease beyond this time in the reflux (+) group. The mean +/- SD bodyweight ratios at 3 years postoperatively were 82.83% +/- 9.73% and 89.45% +/- 8.04% for the reflux (+) and reflux (-) group, respectively (P = .0006). Multivariate analysis revealed that postoperative reflux esophagitis was associated with postoperative body weight loss. Another multivariate analysis revealed preoperative hiatal hernia as an independent predictive factor for postoperative reflux esophagitis. Conclusion: The risk of reflux esophagitis after LDGBI in patients with hiatal hernia should be considered when deciding therapeutic approaches for such patients.
机构:
Leeds Gen Infirm, Leeds Gastroenterol Inst, Leeds LS1 3EX, W Yorkshire, England
Univ Leeds, Leeds Inst Mol Med, Leeds, W Yorkshire, EnglandLeeds Gen Infirm, Leeds Gastroenterol Inst, Leeds LS1 3EX, W Yorkshire, England
Ford, A. C.
;
Suares, N. C.
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机构:
Leeds Gen Infirm, Leeds Gastroenterol Inst, Leeds LS1 3EX, W Yorkshire, EnglandLeeds Gen Infirm, Leeds Gastroenterol Inst, Leeds LS1 3EX, W Yorkshire, England
Suares, N. C.
;
Talley, N. J.
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机构:
Univ Newcastle, Fac Hlth, Newcastle, NSW 2300, AustraliaLeeds Gen Infirm, Leeds Gastroenterol Inst, Leeds LS1 3EX, W Yorkshire, England
机构:
Nippon Med Coll, Dept Internal Med, Div Gastroenterol, Bunkyo Ku, Tokyo 1138603, JapanNippon Med Coll, Dept Internal Med, Div Gastroenterol, Bunkyo Ku, Tokyo 1138603, Japan
Hayashi, Yoshinori
;
Iwakiri, Katsuhiko
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Nippon Med Coll, Dept Internal Med, Div Gastroenterol, Bunkyo Ku, Tokyo 1138603, JapanNippon Med Coll, Dept Internal Med, Div Gastroenterol, Bunkyo Ku, Tokyo 1138603, Japan
Iwakiri, Katsuhiko
;
Kotoyori, Makoto
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Nippon Med Coll, Dept Internal Med, Div Gastroenterol, Bunkyo Ku, Tokyo 1138603, JapanNippon Med Coll, Dept Internal Med, Div Gastroenterol, Bunkyo Ku, Tokyo 1138603, Japan
Kotoyori, Makoto
;
Sakamoto, Choitsu
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机构:
Nippon Med Coll, Dept Internal Med, Div Gastroenterol, Bunkyo Ku, Tokyo 1138603, JapanNippon Med Coll, Dept Internal Med, Div Gastroenterol, Bunkyo Ku, Tokyo 1138603, Japan
机构:
Leeds Gen Infirm, Leeds Gastroenterol Inst, Leeds LS1 3EX, W Yorkshire, England
Univ Leeds, Leeds Inst Mol Med, Leeds, W Yorkshire, EnglandLeeds Gen Infirm, Leeds Gastroenterol Inst, Leeds LS1 3EX, W Yorkshire, England
Ford, A. C.
;
Suares, N. C.
论文数: 0引用数: 0
h-index: 0
机构:
Leeds Gen Infirm, Leeds Gastroenterol Inst, Leeds LS1 3EX, W Yorkshire, EnglandLeeds Gen Infirm, Leeds Gastroenterol Inst, Leeds LS1 3EX, W Yorkshire, England
Suares, N. C.
;
Talley, N. J.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Newcastle, Fac Hlth, Newcastle, NSW 2300, AustraliaLeeds Gen Infirm, Leeds Gastroenterol Inst, Leeds LS1 3EX, W Yorkshire, England
机构:
Nippon Med Coll, Dept Internal Med, Div Gastroenterol, Bunkyo Ku, Tokyo 1138603, JapanNippon Med Coll, Dept Internal Med, Div Gastroenterol, Bunkyo Ku, Tokyo 1138603, Japan
Hayashi, Yoshinori
;
Iwakiri, Katsuhiko
论文数: 0引用数: 0
h-index: 0
机构:
Nippon Med Coll, Dept Internal Med, Div Gastroenterol, Bunkyo Ku, Tokyo 1138603, JapanNippon Med Coll, Dept Internal Med, Div Gastroenterol, Bunkyo Ku, Tokyo 1138603, Japan
Iwakiri, Katsuhiko
;
Kotoyori, Makoto
论文数: 0引用数: 0
h-index: 0
机构:
Nippon Med Coll, Dept Internal Med, Div Gastroenterol, Bunkyo Ku, Tokyo 1138603, JapanNippon Med Coll, Dept Internal Med, Div Gastroenterol, Bunkyo Ku, Tokyo 1138603, Japan
Kotoyori, Makoto
;
Sakamoto, Choitsu
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机构:
Nippon Med Coll, Dept Internal Med, Div Gastroenterol, Bunkyo Ku, Tokyo 1138603, JapanNippon Med Coll, Dept Internal Med, Div Gastroenterol, Bunkyo Ku, Tokyo 1138603, Japan