Park Samina, Kang Chang Hyun, Lee Hyun Joo, Park In Kyu, Kim Young Tae
Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea.
J Thorac Dis. 2020 Mar;12(3):558-567. doi: 10.21037/jtd.2019.12.134.
Reflux symptoms including various extra-esophageal manifestations are commonly reported after esophagectomy. However, the intensity and presentation of reflux are both diverse and variable by patients. In this study we assessed reflux symptoms using the reflux symptom index (RSI) questionnaire in patients who underwent esophagectomy for esophageal cancer to order to identify the prevalence of significant reflux and its risk factors.
From April 2017 to July 2017, we investigated patients who underwent esophagectomy for esophageal cancer. The severity of reflux was evaluated with a self-administered nine-item outcomes instrument (score: 0 to 5). An RSI score ≥13 was considered significant reflux. Multivariable analysis was conducted to identify risk factors.
A total of 151 patients was included (mean age, 64.1±8.8 years; male, n=136, 90.1%). The median time after esophagectomy was 22.6 months. The question regarding heartburn, chest pain, indigestion, or acid coming up was most frequently responded (n=104, 68.9%) with 41 (27.2%) patients presenting significant reflux (mean RSI score, 19.9±6.3). Time after esophagectomy <2 years, vocal cord palsy, retrosternal route of reconstruction, and postoperative weight loss were identified as significant risk factors for RSI ≥13 in the multi-variable analysis.
Reflux related symptoms including extra-esophageal manifestations were common. Our study revealed that short duration after esophagectomy, vocal cord palsy, retrosternal route of reconstruction, and postoperative weight loss were significant associated factors for reflux symptom after esophagectomy.
食管癌切除术后常见反流症状，包括各种食管外表现。然而，反流的强度和表现因人而异。在本研究中，我们使用反流症状指数（RSI）问卷对接受食管癌切除术的患者进行反流症状评估，以确定严重反流的患病率及其危险因素。
2017年4月至2017年7月，我们对接受食管癌切除术的患者进行了调查。采用自行填写的9项结果量表评估反流严重程度（评分：0至5分）。RSI评分≥13分被认为是严重反流。进行多变量分析以确定危险因素。
共纳入151例患者（平均年龄64.1±8.8岁；男性136例，占90.1%）。食管癌切除术后的中位时间为22.6个月。关于烧心、胸痛、消化不良或反酸的问题回答最为频繁（n=104，68.9%），41例（27.2%）患者存在严重反流（平均RSI评分19.9±6.3）。多变量分析确定食管癌切除术后时间<2年、声带麻痹、胸骨后重建路径和术后体重减轻是RSI≥13的显著危险因素。
包括食管外表现在内的反流相关症状很常见。我们的研究表明，食管癌切除术后时间短、声带麻痹、胸骨后重建路径和术后体重减轻是食管癌切除术后反流症状的重要相关因素。
