The Effect of Radical Subtotal Gastrectomy on the Esophageal Motility and Acid Reflux at Short Term Interval / 대한소화관운동학회지

ABSTRACT

BACKGROUND/AIMS: A lymph-node dissection around the abdominal esophagus, vagotomy, and dissection to the phrenoesophageal membrane performed during a radical subtotal gastrectomy result anatomical changes and may result functional changes in the lower esophageal sphincter. We performed this study to define the changes of the esophageal reflux and motility in the development of these complications. METHODS: We performed this study before and after the radical subtotal gastrectomy with the esophageal manometry and 24hour ambulatory esophageal pH monitoring in 16 gastric cancer patients. RESULTS: There were no significant changes of the length, resting pressure of the lower esophageal sphincter, and the velocity of peristalsis in the lower esophageal area after the radical subtotal gastrectomy (3.94+/-0.66 vs. 3,85+/-0.61, 24.93+/-8.68 vs. 24.21+/-9.43, 3.99+/-0.95 vs. 3.79+/-1.01, respectively). There were no significant changes of the number of reflux episodes >or= 5 min (0.56+/-0.96 vs. 0.44+/-1.03), the duration of longest reflux episodes (5.19+/-6.84 vs. 4.25+/-7.22), and the total reflux time of pH below 4 (11.13+/-14.32 vs. 12.19+/-19.11) after the radical subtotal gastrectomy. CONCLUSION: This study suggests that acid reflux and esophageal motility after the radical subtotal gastrectomy might not be affected by anatomical derangement due to the surgical procedure itself.