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Endoscopic and manometric study of the cardia in post-gastrectomy patients
H Sodeyama1, K Ishizaka, C Takahashi
1Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
Insights
Post-gastrectomy patients have a significantly higher incidence of hiatus hernia compared to non-gastrectomy patients. This surgery also leads to decreased lower esophageal sphincter pressure, impacting cardia function.
Area of Science:
- Gastroenterology
- Surgical Outcomes
- Digestive Health
Background:
- Hiatus hernia is a common condition affecting the cardia.
- Gastric surgery can alter esophageal and cardia function.
- Understanding post-gastrectomy complications is crucial for patient care.
Purpose of the Study:
- To determine the incidence of hiatus hernia in post-gastrectomy patients.
- To investigate functional changes in the cardia after gastrectomy.
- To compare hiatus hernia rates between post-gastrectomy and non-gastrectomy individuals.
Main Methods:
- Endoscopic examination of 104 post-gastrectomy and 399 non-gastrectomy patients.
- Diagnosis of hiatus hernia based on cardia morphology during endoscopy.
- Manometric studies on patients with gastric carcinoma and gallstones.
Main Results:
- Hiatus hernia incidence was 37.5% in post-gastrectomy patients versus 19.3% in controls (p<0.01).
- Hernia incidence increased with age in non-gastrectomy patients.
- Lower esophageal sphincter pressure significantly decreased post-gastrectomy but not post-cholecystectomy.
Conclusions:
- Gastrectomy significantly increases the risk of developing a hiatus hernia.
- Functional changes, including reduced lower esophageal sphincter pressure, occur after gastrectomy.
- Further research is needed to explore the long-term implications of these findings.
Abstract:
This study was undertaken to clarify the incidence of hiatus hernia and the functional changes in the cardia of post-gastrectomy patients. One hundred and four post-gastrectomy patients and 399 non-gastrectomy patients were selected for endoscopic study, and the diagnosis of hiatus hernia was made by observing the shape of the cardia inside the stomach. A manometric study was also done on 12 patients with gastric carcinoma and 14 patients with gallstones. Hiatus hernia was observed in 37.5 per cent of the post-gastrectomy patients, this incidence being significantly higher than the 19.3 per cent of the non-gastrectomy patients (p less than 0.01). In the latter group alone the incidence of hernia steadily increased with advancing age. In the post-gastrectomy patients, reflux esophagitis and heartburn were observed in 20.2 per cent and 27.9 per cent, respectively. These incidences tended to be higher in the patients with hernia but there were no significant differences. The manometric study revealed that lower esophageal sphincter pressure was significantly decreased after gastrectomy, but not after cholecystectomy.