scholarly journals Significance of the Lower Esophageal Sphincter Preservation in Preventing Alkaline Reflux Esophagitis in Patients After Total Gastrectomy Reconstructed by Roux-en-Y for Gastric Cancer

2014 ◽  
Vol 99 (2) ◽  
pp. 174-181 ◽  
Author(s):  
Ryouichi Tomita ◽  
Kenichi Sakurai ◽  
Shigeru Fujisaki
Keyword(s):  
Gastric Cancer ◽  
Total Gastrectomy ◽  
Lower Esophageal Sphincter ◽  
Reflux Esophagitis ◽  
Ph Monitoring ◽  
Sphincter Preservation ◽  
Esophageal Ph ◽  
Group A ◽  
Esophageal Sphincter ◽  
Alkaline Reflux

Abstract To clarify the significance of the lower esophageal sphincter (LES) for prevention of alkaline reflux esophagitis (ARE) after total gastrectomy reconstructed by Roux-en-Y (TGRY) for gastric cancer, we investigated LES function and lower esophageal pH in TGRY patients with or without LES preservation. A total of 51 patients 5 years after TGRY were divided into groups A (26 patients without preserved LES) and B (25 patients with preserved LES) and compared with 22 control participants (group C). Manometric study and ambulatory 24-hour esophageal pH monitoring were performed on all patients. Symptomatic and endoscopic AREs in group A were significantly higher than those in group B (P < 0.05). The length of LES and maximum LES pressure in group A were significantly shorter and lower, respectively, than in groups B and C (P < 0.01). The length of LES and maximum LES pressure in patients with symptomatic ARE were significantly shorter and lower, respectively, than in patients without symptomatic ARE (P < 0.01). Percentages of time with pH >7 and pH >8 within 24 hours in group A were significantly higher than those in groups B and C (P < 0.01). Preservation of the LES may be necessary to prevent ARE after TGRY.

Preservation of the lower esophageal sphincter during total gastrectomy for gastric cancer to prevent postoperative reflux esophagitis

Surgery Today ◽  
1995 ◽  
Vol 25 (6) ◽  
pp. 507-514 ◽  
Author(s):  
Toshihiro Hirai ◽  
Shuji Saeki ◽  
Kei Matsuki ◽  
Yoshinori Yamashita ◽  
Takashi Iwata ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Total Gastrectomy ◽  
Lower Esophageal Sphincter ◽  
Reflux Esophagitis ◽  
Postoperative Reflux ◽  
Esophageal Sphincter

Positioning of the pH-probe by manometry or radiography for monitoring of the esophagus: Influence on diagnostic results?

2003 ◽  
Vol 44 (4) ◽  
pp. 360-362
Author(s):  
K. Aksglæde ◽  
P. Thommesen
Keyword(s):  
Gastroesophageal Reflux ◽  
Lower Esophageal Sphincter ◽  
Ph Monitoring ◽  
Gastroesophageal Junction ◽  
Ph Probe ◽  
Rye Bread ◽  
Esophageal Ph ◽  
Significant Difference ◽  
Oblique Position ◽  
Esophageal Sphincter

Purpose: To correlate gastroesophageal reflux (GER), demonstrated by radiography using bread and barium, with 24-h pH monitoring in the esophagus, with the pH-probe positioned by manometry or radiology. Material and Methods: In all, 146 patients, 41 females and 105 males, with a median age of 47 years, suspected of GER were examined. Radiography was performed with the patient in the supine right oblique position during mastication and swallowing a piece of rye bread with liver pâté and barium. The test was positive if barium was observed more than 5 cm proximal to the gastroesophageal junction (GEJ). An antimony pH-probe was placed 5 cm above the lower esophageal sphincter determined by manometry, or 5 cm above the GEJ determined by radiography. The total time of esophageal pH < 4 exceeding 5% was considered pathological. Results: The radiological method had a specificity of 100% and a sensitivity of 52% compared to 24-h pH monitoring with the pH-probe positioned manometrically, and a specificity of 100% and sensitivity of 67% with the pH-probe positioned by radiography, with no significant difference between the two positionings. Conclusion: In 146 patients submitted to 24-h pH monitoring, the pH-probe could be placed as safely by radiography as by manometry.

The Importance of Hiatal Hernia in Reflux Esophagitis Compared with Lower Esophageal Sphincter Pressure or Smoking

1991 ◽  
Vol 13 (6) ◽  
pp. 628-643 ◽  
Author(s):  
Stephen J. Sontag ◽  
Thomas G. Schnell ◽  
Todd Q. Miller ◽  
Bernard Nemchausky ◽  
Rose Serlovsky ◽  
...  
Keyword(s):  
Hiatal Hernia ◽  
Lower Esophageal Sphincter ◽  
Reflux Esophagitis ◽  
Lower Esophageal Sphincter Pressure ◽  
Sphincter Pressure ◽  
Esophageal Sphincter

scholarly journals Use of 24 h Esophageal pH Monitoring to Demonstrate Alkaline Reflux as a Complication of Gastric Bypass Surgery

1994 ◽  
Vol 8 (6) ◽  
pp. 395-397
Author(s):  
J Patrick Shoenut ◽  
Rudy G Danzinger
Keyword(s):  
Bypass Surgery ◽  
Ph Monitoring ◽  
Surgical Complication ◽  
Gastric Bypass Surgery ◽  
Acid Reflux ◽  
Esophageal Ph Monitoring ◽  
Barium Swallow ◽  
Esophageal Ph ◽  
Nocturnal Cough ◽  
Alkaline Reflux

A 35-year-old female who had previously undergone a gastric stapling procedure for morbid obesity presented with a persistent nocturnal cough that was treated over a three-year period as a gastric acid reflux complication of the bypass surgery. A barium swallow demonstrated gastroesophageal reflux, but the symptoms did not resolve after treatment with omeprazole and cisapride. Twenty-four hour esophageal pH monitoring subsequently found alkaline reflux in excess of 17% of the total time, with no acid reflux demonstrated. Surgical revision of the bypass Leaving the hiatus alone corrected the reflux complication and the symptoms resolved without further treatment. The diagnostic capability of pH monitoring is illustrated in a patient with an unusual surgical complication.

Endoscopic Ultrasonography of the Lower Esophageal Sphincter in Reflux Esophagitis and Achalasia

1994 ◽  
Vol 6 (4) ◽  
pp. 334-341
Author(s):  
Shori KUNUGI ◽  
Munehiro KOMATSU ◽  
Toshikazu SEKIGUCHI ◽  
Osamu KAWAMURA ◽  
Tsutomu HORIKOSHI ◽  
...  
Keyword(s):  
Lower Esophageal Sphincter ◽  
Endoscopic Ultrasonography ◽  
Reflux Esophagitis ◽  
Esophageal Sphincter
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