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Ann Thorac Surg 2004;78:298-302
© 2004 The Society of Thoracic Surgeons

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Original article: general thoracic

Influence of esophageal carcinoma operations on gastroesophageal reflux

^a Department of Thoracic and Cardiovascular Surgery, First Hospital, College of Medicine, Zhejiang University, Hangzhou, China
^b School of Medicine, Hangzhou Normal College, Hangzhou, China

Accepted for publication November 25, 2003.

^* Address reprint requests to Dr Hu, Department of Thoracic and Cardiovascular Surgery, First Hospital, College of Medicine, Zhejiang University, No 261 Qingchun Rd, Hangzhou, 310003, Zhejiang, China
e-mail: hjsl{at}mail.hz.zj.cn

BACKGROUND: Gastroesophageal reflux occurs more easily after esophageal carcinoma operations. Our objective was to compare the influence of three kinds of esophageal carcinoma operations on reflux.

METHODS: From May 1999 to May 2002, esophageal carcinoma operations were performed on 30 consecutive patients through left thoracotomy, including 10 cases completed with supraaortic, ante-aortic gastroesophageal anastomosis, 10 cases with subaortic gastroesophageal anastomosis, and 10 cases with apicothoracic retro-aortic gastroesophageal anastomosis. A 24-hour esophageal pH was recorded for every patient 3 months after the operation.

RESULTS: The number of reflux episodes per 24 hours (No. of episodes), the number of reflux episodes greater than or equal to 5 minutes per 24 hours (No. 5 min), the time in minutes of the longest reflux episode recorded (longest episode) and the cumulative time of the esophageal pH less than 4 (total time that pH < 4) are all beyond normal limits. The difference in number of episodes between supraaortic, ante-aortic, and subaortic gastroesophageal anastomosis groups is not significant; but the other indexes are higher in the supraaortic, ante-aortic anastomosis group with significance (p < 0.05). The difference in number of episodes between supraaortic, ante-aortic, and apicothoracic retro-aortic gastroesophageal anastomosis groups is not significant while the other indexes are much higher in the supraaortic, ante-aortic anastomosis group with significance (p < 0.05); the difference in number of episodes between apicothoracic retro-aortic and subaortic gastroesophageal anastomosis groups is not significant while the other indexes are lower in the apicothoracic retro-aortic anastomosis group with significance (p < 0.05).

CONCLUSIONS: Gastroesophageal reflux occurred after all three types of esophageal carcinoma operations. The reflux is less severe in the apicothoracic retro-aortic anastomosis group than in the other two groups. The esophageal carcinoma operation with apicothoracic retro-aortic gastroesophageal anastomosis has more advantages to alleviate postoperative gastroesophageal reflux.

This article has been cited by other articles:

				J. Hu, R. Li, L. Sun, and Y. Ni Comparison of influence of esophageal carcinoma operations on pulmonary function Eur. J. Cardiothorac. Surg., July 1, 2005; 28(1): 16 - 18. [Abstract] [Full Text] [PDF]