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- Title
Acid Secretion and Its Relationship to Esophageal Reflux Symptom in Patients with Subtotal Gastrectomy.
- Authors
Oh, Hyun Jin; Choi, Myung-Gyu; Park, Jae Myung; Song, Kyo Young; Yoo, Han Mo
- Abstract
<bold>Background: </bold>Esophageal reflux symptom has been reported as common in patients with subtotal gastrectomy. Management of postoperative esophageal reflux symptom is not satisfactory. The aim of this study is to investigate prevalence of esophageal reflux symptom after subtotal gastrectomy and assess factors affecting esophageal reflux symptom in subtotal gastrectomy patients.<bold>Methods: </bold>We prospectively enrolled 100 consecutive patients with subtotal gastrectomy who were regularly followed up by endoscopic examination. Acid secretory capacity was assessed by measuring messenger RNA (mRNA) expression of H+/K+-adenosine triphosphatase (ATPase) via real-time polymerase chain reaction (PCR) in biopsy specimens.<bold>Results: </bold>In total, 47 % of patients had typical esophageal reflux symptom, where heartburn or regurgitation was experienced at least weekly. Age, sex, body mass index, and type of reconstruction did not differ between esophageal reflux and non-esophageal-reflux groups. The esophageal reflux group had longer duration from time of operation until study (median 5.0 versus 3.6 years; P = 0.017). Hill grade for gastroesophageal (GE) flap valve was higher in the esophageal reflux group than in the non-esophageal-reflux group (P = 0.027). H+/K+-ATPase mRNA expression was higher in the esophageal reflux group than in the non-esophageal-reflux group [3967.6 (± 7583.7) versus 896.2 (± 1456.0); P = 0.006]. Multivariate analysis revealed that postoperative duration, H+/K+-ATPase mRNA expression level, and GE flap valve disruption were significantly associated with esophageal reflux symptom development.<bold>Conclusions: </bold>Esophageal reflux symptom is common in patients after subtotal gastrectomy, possibly because of anti-reflux-barrier impairment and preservation of acid secretory capacity following surgery. Optimal acid suppression may be helpful in managing postoperative esophageal reflux symptom.
- Subjects
GASTROESOPHAGEAL reflux diagnosis; RNA metabolism; ADENOSINE triphosphatase; COMPARATIVE studies; GASTRECTOMY; GASTRIC acid; GASTROESOPHAGEAL reflux; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; POLYMERASE chain reaction; RESEARCH; EVALUATION research; SURGICAL complications; DISEASE prevalence; DIAGNOSIS
- Publication
Digestive Diseases & Sciences, 2018, Vol 63, Issue 3, p703
- ISSN
0163-2116
- Publication type
journal article
- DOI
10.1007/s10620-018-4923-9