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Surgery Today
Published in: Surgery Today 12/2019

01-12-2019 | Esophageal Cancer | Original Article

The impact of cervical lymph node dissection on acid and duodenogastroesophageal reflux after intrathoracic esophagogastrostomy following transthoracic esophagectomy

Authors: Soichiro Asai, Masahide Fukaya, Kazushi Miyata, Keita Itatsu, Ryoji Miyahara, Kazuhiro Furukawa, Tomoki Ebata, Masato Nagino

Published in: Surgery Today | Issue 12/2019

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Abstract

Purpose

The aim of this study was to evaluate the impact of cervical lymph node dissection on acid reflux and duodenogastroesophageal reflux (DGER) in patients undergoing transthoracic esophagectomy with gastric tube reconstruction and intrathoracic esophagogastrostomy.

Methods

Thirty-one patients receiving transthoracic esophagectomy with gastric tube reconstruction by intrathoracic esophagogastrostomy were divided into the following two groups: a two-field lymph node dissection group (2F group) and a three-field lymph node dissection group (3F group). All patients underwent 24-h pH and bilirubin monitoring and gastrointestinal endoscopy at 1 year after surgery. The 24-h pH and bilirubin monitoring results, endoscopic findings, and reflux symptoms were compared between the 2 groups.

Results

No acid reflux was observed in the 2F group, whereas it was observed in 6 (40%) patients in the 3F group (p = 0.007). DGER was found in 2 patients (13%) in the 2F group and in 8 (53%) in the 3F group (p = 0.023). Four patients (25%) in the 2F group and 9 (60%) in the 3F group (p = 0.048) had reflux esophagitis.

Conclusion

Cervical lymph node dissection increases acid reflux and DGER and can lead to an increase in the incidence of reflux esophagitis in patients undergoing intrathoracic esophagogastrostomy.
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Metadata
Title
The impact of cervical lymph node dissection on acid and duodenogastroesophageal reflux after intrathoracic esophagogastrostomy following transthoracic esophagectomy
Authors
Soichiro Asai
Masahide Fukaya
Kazushi Miyata
Keita Itatsu
Ryoji Miyahara
Kazuhiro Furukawa
Tomoki Ebata
Masato Nagino
Publication date
01-12-2019
Publisher
Springer Singapore
Published in
Surgery Today / Issue 12/2019
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-019-01835-4

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