Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 6028566, Japan.
Langenbecks Arch Surg. 2013 Jun;398(5):697-701. doi: 10.1007/s00423-012-0921-0. Epub 2012 Feb 17.
We investigated postoperative symptoms related to reflux esophagitis in patients who underwent esophagogastrostomy reconstruction after proximal gastrectomy (PG) by conducting a questionnaire survey.
Quality of life was assessed using two different questionnaires, the gastrointestinal symptom rating scale (GSRS) for postoperative abdominal symptoms and F-scale for reflux esophagitis. The survey was conducted among 39 patients who underwent esophagogastrostomy after proximal gastrectomy for gastric cancer in the upper third of the stomach, and findings were compared with those in patients who underwent total gastrectomy (TG).
The questionnaire was returned by 32 of 39 patients (82%) in the PG group and 40 of 45 patients (89%) in the TG group. On GSRS, the score for indigestion syndrome tended to be higher in the TG group than in the PG group (p < 0.10), and the score for constipation was significantly higher in the PG group than in the TG group (p < 0.05). The score for reflux syndrome, however, was almost the same in both groups. Similarly, there was no significant difference in the frequency of GERD symptoms between the PG and TG groups on F-scale questionnaire (47% vs. 63%, p = 0.18).
Esophagogastrostomy after PG in an end-to-side manner with creation of acute angle at the anastomosis is not associated with an increased risk of reflux esophagitis compared with TG.
我们通过问卷调查的方式，调查了近端胃切除术后胃食管吻合术重建患者与反流性食管炎相关的术后症状。
使用胃肠道症状评分量表（GSRS）评估术后腹部症状和 F 量表评估反流性食管炎的生活质量。该调查在 39 例因胃上部癌行近端胃切除术后行胃食管吻合术的患者中进行，并与行全胃切除术（TG）的患者进行了比较。
PG 组的 39 例患者中有 32 例（82%）和 TG 组的 45 例患者中有 40 例（89%）返回了问卷。在 GSRS 上，TG 组消化不良综合征的评分倾向于高于 PG 组（p<0.10），而 PG 组的便秘评分明显高于 TG 组（p<0.05）。然而，两组的反流综合征评分几乎相同。同样，F 量表问卷调查中，PG 组和 TG 组的 GERD 症状频率也无显著差异（47%vs.63%，p=0.18）。
与 TG 相比，近端胃切除术后行端侧吻合术并在吻合处形成锐角的胃食管吻合术并不会增加反流性食管炎的风险。
