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ID 53006
フルテキストURL
著者
Yamada, Eiji Okayama Univ, Dept Gastroenterol Surg Transplant & Surg Oncol, Grad Sch Med Dent & Pharmaceut Sci
Shirakawa, Yasuhiro Okayama Univ, Dept Gastroenterol Surg Transplant & Surg Oncol, Grad Sch Med Dent & Pharmaceut Sci
Yamatsuji, Tomoki Kawasaki Hosp, Kawasaki Med Sch, Dept Gen Surg
Sakuma, Leon Kawasaki Univ Med Welf, Dept Universal Design
Takaoka, Munenori Kawasaki Hosp, Kawasaki Med Sch, Dept Gen Surg
Yamada, Takako Kawasaki Hosp, Kawasaki Med Sch, Dept Gen Surg
Noma, Kazuhiro Okayama Univ, Dept Gastroenterol Surg Transplant & Surg Oncol, Grad Sch Med Dent & Pharmaceut Sci
Sakurama, Kazufumi Okayama Univ, Dept Gastroenterol Surg Transplant & Surg Oncol, Grad Sch Med Dent & Pharmaceut Sci
Fujiwara, Yasuhiro Okayama Univ, Dept Gastroenterol Surg Transplant & Surg Oncol, Grad Sch Med Dent & Pharmaceut Sci
Tanabe, Shunsuke Okayama Univ, Dept Gastroenterol Surg Transplant & Surg Oncol, Grad Sch Med Dent & Pharmaceut Sci
Nagasaka, Takeshi Okayama Univ, Dept Gastroenterol Surg Transplant & Surg Oncol, Grad Sch Med Dent & Pharmaceut Sci
Fujiwara, Toshiyoshi Okayama Univ, Dept Gastroenterol Surg Transplant & Surg Oncol, Grad Sch Med Dent & Pharmaceut Sci
Naomoto, Yoshio Kawasaki Hosp, Kawasaki Med Sch, Dept Gen Surg
抄録
Background: Conventional reconstruction after an esophagectomy uses a gastric tube, which commonly causes several postoperative complaints such as gastric acid reflux in long-term survival cases. Intestinal interposition between the remnant esophagus and the stomach is an option to reduce complaints, and in this study, the advantages of jejunal interposition reconstruction with a stomach preserving esophagectomy (SPE) were assessed. Materials and methods: Eleven cases of jejunal interposition with an SPE and 16 cases with gastric tube reconstruction as a control were subject to a comparison of operation time, amount of bleeding, postoperative quality of life, and endoscopic findings. Results: The SPE group had a longer operation time (SPE: 560 +/- 121 min, control 414 +/- 83 min, P = 0.038), whereas there was no significant difference in blood loss. Postoperative weight loss was significantly recovered in the SPE group (SPE versus control = 94.0 +/- 5.4% versus 87.5 +/- 4.7% at 3 mo, P = 0.017; 97.2 +/- 7.5% versus 85.0 +/- 5.2% at 6 mo, P = 0.010), and there was a significant decrease in the occurrence of reflux symptoms such as heartburn, odynophagia, and cough when jejunal interposition with an SPE was done. Furthermore, reflux esophagitis and Barrett's epithelium were found in six out of 12 cases (50%) of the control group by postoperative endoscopy, while no cases in the SPE group had either condition (P < 0.01). Conclusions: This reconstruction method is a promising option to improve postoperative quality of life, mainly due to the long-term elimination of reflux esophagitis, which assists in the recovery of postoperative weight loss.
キーワード
Esophageal cancer
Jejunal interposition reconstruction
Stomach preserving esophagectomy
Postoperative QOL
Reflux esophagitis
発行日
2012-12
出版物タイトル
Journal of Surgical Research
178巻
2号
出版者
Academic Press Inc Elsevier Science
開始ページ
700
終了ページ
707
ISSN
0022-4804
資料タイプ
学術雑誌論文
関連URL
http://ousar.lib.okayama-u.ac.jp/metadata/52962
言語
English
OAI-PMH Set
岡山大学
著作権者
(C) 2012 Elsevier Inc. All rights reserved.
論文のバージョン
author
査読
有り
DOI
Web of Sience KeyUT