Department of Surgery, Gunma Prefectural Cardiovascular Center, Maebashi, Japan; Department of General Surgical Science, Gunma University, Graduate School of Medicine, Maebashi, Japan.
Ann Thorac Surg. 2013 Nov;96(5):1833-8. doi: 10.1016/j.athoracsur.2013.06.034. Epub 2013 Aug 30.
Reflux esophagitis is a significant problem in patients after an esophagectomy with gastric tube reconstruction. The pathogenesis of reflux esophagitis is not fully understood. The aim of the present study was to evaluate whether gastropyloric motility influences the pathogenesis of reflux esophagitis after an esophagectomy.
Thirty esophagectomized patients were assessed by endoscopy and manometry. The patients were classified into 3 groups according to the postoperative period as follows: Group 1 (less than 12 months), group 2 (12 to 24 months), and group 3 (more than 24 months). Gastropyloric motor activity was quantified by calculating the motility index, which is equivalent to the area under the contractile waves.
Reflux esophagitis was observed in 80% of group 1, 80% of group 2, and 30% of group 3. The severity of reflux esophagitis decreased with time. Contractions of the gastric body were not observed in any of the patients. The antral motility index in group 3 was significantly greater than that in groups 1 and 2. The pyloric motility index progressively increased. The severity of reflux esophagitis is significantly associated with gastropyloric motor activity.
The severity of reflux esophagitis decreases with time, coupled with recovery of antropyloric motor activity. Gastropyloric motor activity plays an important role in the genesis of reflux esophagitis after an esophagectomy.
胃管重建后的食管切除术后患者会出现明显的反流性食管炎。反流性食管炎的发病机制尚未完全阐明。本研究旨在评估胃幽门运动是否会影响食管切除术后反流性食管炎的发病机制。
通过内镜和测压法评估 30 例食管切除术后患者。根据术后时间将患者分为 3 组：组 1（<12 个月）、组 2（12 至 24 个月）和组 3（>24 个月）。通过计算运动指数来量化胃幽门运动，运动指数等同于收缩波下的面积。
组 1 中 80%、组 2 中 80%和组 3 中 30%的患者出现反流性食管炎。反流性食管炎的严重程度随时间而降低。所有患者均未观察到胃体收缩。组 3 的胃窦运动指数明显大于组 1 和组 2。幽门运动指数逐渐增加。反流性食管炎的严重程度与胃幽门运动活性显著相关。
反流性食管炎的严重程度随时间降低，同时胃幽门运动活性恢复。胃幽门运动活性在食管切除术后反流性食管炎的发生中起重要作用。
