Intraesophageal pressure in patients receiving proximal gastrectomy with hinged double flap method for gastric cancer: a retrospective cohort study
Yoshihiro Saeki, Kazuaki Tanabe, Hiroshi Ota, Emi Chikuie, Yuki Takemoto, Nozomi Karakuchi, Osamu Miura, Eiichiro Toyama, Hideki Ohdan- General Medicine
- Surgery
Background:
Objective functional assessment of esophagogastric anastomosis in patients who underwent proximal gastrectomy with the hinged double flap method for gastric cancer has not been well investigated. This study aimed to perform a functional analysis of reconstruction using high-resolution impedance manometry (HRIM).
Materials and Methods:
We enrolled 25 patients who underwent proximal gastrectomy for gastric cancer between May 2015 and April 2020 and subsequently underwent HRIM postoperatively. Eligible questionnaires (Postgastrectomy Syndrome Assessment Scale -37 [PGSAS-37]) were retrieved from 16 patients. The association between HRIM data and PGSAS-37 was analyzed.
Results:
The amplitudes of distal esophageal peristaltic waves, contractile front velocity, and distal latency assessed by HRIM were almost normal after surgery. Most patient’s lower esophageal sphincter (LES) resting pressure created by the hinged double flap was within normal limits. Conversely, LES residual pressure values during swallowing-induced relaxation were abnormally high in most patients, and the lower the values, the more severe the reflux and diarrhea symptoms (
Conclusion:
LES residual pressure and IRP values in HRIM correlated with reflux symptoms in patients after proximal gastrectomy.