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[Intrathoracic gastric function after esophagectomy for patients with esophageal cancer]
1Department of Thoracic Surgery, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing.
Objective:
To reveal the physiological changes of intrathoracic stomach after esophagectomy and find ways to improve patients' digestive function.
Methods:
In twenty preoperative and 41 postoperative patients, the physiologic functions of stomach were studied and compared with radioisotope technique, pressure measurement, 24-hour pH monitoring and gastroscopy.
Results:
The emptying of semisolid food from the intrathoracic stomach was much delayed (P < 0.01); its acid secretion was decreased in the early postoperative period (P < 0.01) but it restored to normal one year later. Fasting serum gastrin level was higher (P < 0.01) in the early postoperative period but showed a partial restoration one year later. The high pressure zone at anastomosis helped prevent gastroesophageal reflux. High incidence of gastritis was found in intrathoracic stomach and this may be related to gastric stasis.
Conclusion:
Performing scarf telescoping anastomosis and pyloraplasty, giving a certain amount of pepsin, diluted hydrochloric acid and anti-gastrin drug to early postoperative patients should be beneficial to reducing the symptoms and normalizing patients' digestive function.