J Korean Surg Soc.  2010 Oct;79(4):246-252. 10.4174/jkss.2010.79.4.246.

The Risk Factors of Reflux Complication after Gastrectomy for Proximal Gastric Cancer

• Kwag SJ
• Jung SH
• Lee YJ
• Jung CY
• Park ST
• Choi SK
• Hong SC
• Jung EJ
• Joo YT
• Ha WS

• KMID: 2145025
• DOI: http://doi.org/10.4174/jkss.2010.79.4.246

Abstract

PURPOSE
The aim of this study was to investigate the risk factors of reflux associated complications (reflux symptoms, reflux esophagitis, and esophageal stricture) after gastrectomy for proximal gastric cancer.
METHODS
150 patients with proximal gastric cancer were included from January 2005 to December 2008. Their medical and surgical records were retrospectively analyzed concerning clinical and pathologic characteristics, operation methods, morbidity, reflux associated complications and nutritional states.
RESULTS
Tumor sizes and operation methods were statistically significant in univariate analysis of risk factors for reflux associated complications (P<0.05). However, only operation methods were statistically significant in multivariate analysis (P=0.00). We, thus, compared operation methods. There were no significant differences in morbidity, body weight, hemoglobin, serum cholesterol, protein and albumin between total gastrectomy groups and proximal gastrectomy groups (P>0.05). However, reflux complications were significantly more common in proximal gastrectomy groups (72.4%) than in total gastrectomy groups (29.5%). Severe reflux esophagitis (LA classification C or D) was found in only proximal gastrectomy groups.
CONCLUSION
Total gastrectomy is favorable for proximal early gastric cancer in terms of reduced esophageal reflux complications.

Keyword

Stomach neoplasm; Gastroesophageal reflux; Esophagitis; Esophageal stenosis; Total gastrectomy

MeSH Terms

Body Weight
Cholesterol
Esophageal Stenosis
Esophagitis
Esophagitis, Peptic
Gastrectomy
Gastroesophageal Reflux
Hemoglobins
Humans
Multivariate Analysis
Retrospective Studies
Risk Factors
Stomach Neoplasms
Cholesterol
Hemoglobins

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