Reducing the Gastroesophageal Reflux with Lip-Type Reinforcement Technique during Intrathoracic Esophagogastrostomy

摘要

Background/Aims: Gastroesophageal reflux is a Significant problem after esophagogastrestomy, and impact considerably upon the quality of patients' lives. Aims of this study were to evaluate the operative effects in prevention of reflux with lip-type reinforcement during intrathoracic esophagogastric anastomosis. Methodology: From January 2005 to December 2009, 216 patients received circular stapled esophagogastrostomy with lip-type reinforcement (LR group), and 69 patients with standard reinforcement (SR group) at our hospital. Major observation parameters were symptoms of reflux and dysphagia. Results: No differences in clinicopathologic characteristics between two groups, in addition to the incidence of anastomotic leakage was less in LR group (p=0.039). Grade of dysphagia and anastomotic stricture also were not different between two groups (p>0.05). Symptoms of reflux were better controlled in patients with lip-type reinforcement than standard reinforcement (p<0.001). In LR group, 71.3% were asymptorriatic with respect to reflux compared to 29.7% in SR group (p<0.001). The incidence of reflux esophagitis was 23.5% in LR group and 58.3% in SR group (p<0.001). There was a significant correlation between reflux symptpms and endoscopic findings of reflux esophagitis (p=0.001). Conclusions: Lip-type reinforcement is simple to perform, and effective in controlling gastroesophageal refliix and decreasing anastomotic leakage in majority of patients after esophagogastrostomy.