OVERNIGHT pH MONITORING OF THE PATIENTS UNDERGONE PROXIMAL GASTRECTOMY

Abstract

We investigated overnight pH monitoring in six patients undergone proximal gastrectomy for gastric cancer. Three types of reconstructions were performed. Round lifting group: anastomosis at anterior wall of the residual stomach with round lifting (n=4). His angle plasty: at anterior wall with His angle plasty (n=1). Lesser curvature: simply esophagogastrostomy at lesser curvature (n=1). Overnight pH monitoring was performed at 3rd week, and endoscopic study was done at 6th month after surgery. The mean pH levels of the residual stomach in round lifting group were 3.50, 1.24, 1.32 and 7.56, and those of the esophagus were 5.63, 2.87, 6.21 and 6.95. In the His angle plasty case, the mean pHs were 7.36 at the residual stomach and 6.91 at the esophagus. In the lesser curvature case, 7.69 and 8.04, respectively. Three patients complained of heartburns, and they were revealed reflux esophagitis by endoscopic study. We considered that the pHs of the residual stomach of the patients undergone proximal gastrectomy were different from each other, therefore, we have to measure the pH for recognizing whether the residual stomach is acid or alkaline and cure the patients with reflux esophagitis with adequate medicine.