Postoperative reflux esophagitis in laparoscopic distal gastrectomy with Billroth-I reconstruction for gastric cancer: Nutritional effect and preoperative risk factors

被引:2
作者
Tsuchiya, Hiroshi [1 ]
Yasufuku, Itaru [1 ]
Fukada, Masahiro [1 ]
Higashi, Toshiya [1 ]
Asai, Ryuichi [1 ]
Sato, Yuta [1 ]
Tajima, Jessi Yu [1 ]
Kiyama, Shigeru [1 ]
Tanaka, Yoshihiro [1 ]
Okumura, Naoki [1 ]
Murase, Katsutoshi [1 ]
Takahashi, Takao [1 ]
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
关键词
gastric cancer; laparoscopic surgery; reflux esophagitis; ROUX-EN-Y; DELTA-SHAPED ANASTOMOSIS; QUALITY-OF-LIFE; GASTROESOPHAGEAL-REFLUX; HIATAL-HERNIA; DISEASE; ASSOCIATION; MECHANISMS; OUTCOMES; SAFETY;
D O I
10.1111/ases.13225
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
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.
引用
收藏
页码:695 / 705
页数:11
相关论文
共 32 条
[1]   Role of hiatus hernia and gastric mucosal atrophy in the development of reflux esophagitis in the elderly [J].
Amano, K ;
Adachi, K ;
Katsube, T ;
Watanabe, M ;
Kinoshita, Y .
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, 2001, 16 (02) :132-136
[2]   The endoscopic assessment of esophagitis: A progress report on observer agreement [J].
Armstrong, D ;
Bennett, JR ;
Blum, AL ;
Dent, J ;
deDombal, FT ;
Galmiche, JP ;
Lundell, L ;
Margulies, M ;
Richter, JE ;
Spechler, SJ ;
Tytgat, GNJ ;
Wallin, L .
GASTROENTEROLOGY, 1996, 111 (01) :85-92
[3]   Classification of surgical complications - A new proposal with evaluation in a cohort of 6336 patients and results of a survey [J].
Dindo, D ;
Demartines, N ;
Clavien, PA .
ANNALS OF SURGERY, 2004, 240 (02) :205-213
[4]   Comorbid occurrence of laryngeal or pulmonary disease with esophagitis in United States military veterans [J].
ElSerag, HB ;
Sonnenberg, A .
GASTROENTEROLOGY, 1997, 113 (03) :755-760
[5]   Effect of hiatal hernia on proximal oesophageal acid clearance in gastro-oesophageal reflux disease patients [J].
Emerenziani, S ;
Habib, FI ;
Ribolsi, M ;
Caviglia, R ;
Guarino, MPL ;
Petitti, T ;
Cicala, M .
ALIMENTARY PHARMACOLOGY & THERAPEUTICS, 2006, 23 (06) :751-757
[6]   Meta-analysis: the epidemiology of noncardiac chest pain in the community [J].
Ford, A. C. ;
Suares, N. C. ;
Talley, N. J. .
ALIMENTARY PHARMACOLOGY & THERAPEUTICS, 2011, 34 (02) :172-180
[7]   Clinical significance of hiatal hernia in the development of gastroesophageal reflux after distal gastrectomy for cancer of the stomach [J].
Fujiwara, Yoshinori ;
Nakao, Koji ;
Inoue, Takashi ;
Koishi, Kenji ;
Nishio, Yoshimasa ;
Yagyu, Ryuichirou ;
Nakagawa, Kazuhiko ;
Yamamura, Takehira .
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, 2006, 21 (07) :1103-1107
[8]   Mechanisms of acid gastroesophageal reflux in the Japanese population [J].
Hayashi, Yoshinori ;
Iwakiri, Katsuhiko ;
Kotoyori, Makoto ;
Sakamoto, Choitsu .
DIGESTIVE DISEASES AND SCIENCES, 2008, 53 (01) :1-6
[9]   Comparison of Billroth I and Roux-en-Y Reconstruction after Distal Gastrectomy for Gastric Cancer: One-year Postoperative Effects Assessed by a Multi-institutional RCT [J].
Hirao, Motohiro ;
Takiguchi, Shuji ;
Imamura, Hiroshi ;
Yamamoto, Kazuyoshi ;
Kurokawa, Yukinori ;
Fujita, Junya ;
Kobayashi, Kenji ;
Kimura, Yutaka ;
Mori, Masaki ;
Doki, Yuichiro .
ANNALS OF SURGICAL ONCOLOGY, 2013, 20 (05) :1591-1597
[10]  
Hoshihara Yoshio, 2004, Nihon Rinsho, V62, P1459