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ID 53006
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Author
Yamada, Eiji
Yamatsuji, Tomoki
Sakuma, Leon
Takaoka, Munenori
Yamada, Takako
Noma, Kazuhiro Kakenhi
Sakurama, Kazufumi
Fujiwara, Yasuhiro
Fujiwara, Toshiyoshi ORCID Kakenhi
Naomoto, Yoshio
Abstract
Background: Conventional reconstruction after an esophagectomy uses a gastric tube, which commonly causes several postoperative complaints such as gastric acid reflux in long-term survival cases. Intestinal interposition between the remnant esophagus and the stomach is an option to reduce complaints, and in this study, the advantages of jejunal interposition reconstruction with a stomach preserving esophagectomy (SPE) were assessed. Materials and methods: Eleven cases of jejunal interposition with an SPE and 16 cases with gastric tube reconstruction as a control were subject to a comparison of operation time, amount of bleeding, postoperative quality of life, and endoscopic findings. Results: The SPE group had a longer operation time (SPE: 560 +/- 121 min, control 414 +/- 83 min, P = 0.038), whereas there was no significant difference in blood loss. Postoperative weight loss was significantly recovered in the SPE group (SPE versus control = 94.0 +/- 5.4% versus 87.5 +/- 4.7% at 3 mo, P = 0.017; 97.2 +/- 7.5% versus 85.0 +/- 5.2% at 6 mo, P = 0.010), and there was a significant decrease in the occurrence of reflux symptoms such as heartburn, odynophagia, and cough when jejunal interposition with an SPE was done. Furthermore, reflux esophagitis and Barrett's epithelium were found in six out of 12 cases (50%) of the control group by postoperative endoscopy, while no cases in the SPE group had either condition (P < 0.01). Conclusions: This reconstruction method is a promising option to improve postoperative quality of life, mainly due to the long-term elimination of reflux esophagitis, which assists in the recovery of postoperative weight loss.
Keywords
Esophageal cancer
Jejunal interposition reconstruction
Stomach preserving esophagectomy
Postoperative QOL
Reflux esophagitis
Published Date
2012-12
Publication Title
Journal of Surgical Research
Volume
volume178
Issue
issue2
Publisher
Academic Press Inc Elsevier Science
Start Page
700
End Page
707
ISSN
0022-4804
Content Type
Journal Article
Related Url
http://ousar.lib.okayama-u.ac.jp/metadata/52962
language
英語
Copyright Holders
(C) 2012 Elsevier Inc. All rights reserved.
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author
Refereed
True
DOI
Web of Science KeyUT