Clinical evaluation of narrow gastric tube reconstruction after proximal gastrectomy

Abstract

It is the hardest problem for proximal gastrectomy that reflux esophagitis can occur after the operation. In our institution narrow gastric tube reconstruction has been employed as a safe and convenient method since 2002. In order to evaluate the usefulness of the method, this study was made to examine subjective symptoms due to postoperative reflux esophagitis by using the F-scale interview table, as well as to grasp the status of occurrence of reflux esophagitis objectively based on endoscopic studies. Twenty-two patients who had undergone proximal gastrectomy in our institution from December 2002 to November 2007 were enrolled in this study to compare with 20 patients with early gastric cancer performed total gastrectomy in the same period. In both patient groups more than 70% of the subjects had reflux esophagitis like symptoms based on the F-scale interview table. Eleven out of 16(68.7%) patients who underwent proximal gastrectomy followed by endoscopic studies had findings of reflux esophagitis. However, Grade C or D in accordance with the Los Angeles classification that can create clinical problems was noted in only 18.8% of them.
It is considered that further devices in narrow gastric tube reconstruction are required including development of new evaluation methods for postoperative reflux esophagitis.