Acid reflux and duodeno-gastro-esophageal reflux after esophagectomy for cancer

Objective Investigate the effect of acid reflux and duodenogartroesophageal reflux (DGER) on damage to remnant esophageal mucosa after esophagectomy. Methods Questionnair of gastroesophageal symptoms, endoscopy and twenty-four hour pH and spectrometric bilirubin monitoring of the esophagus were performed in thirty-two patients who underwent esophagectomy for their cancer. Results The incidence of postoperative reflux symptom was 65.6%. The incidence of reflux esophagitis was 75.0%. Barrett esophagus was observed in 2 patients (6. 2% ). 28. 1% of patients had only acid reflux. 15.6% patients had only DGER. 53.1 % of patients had both acid reflux and DGER by analysis of acid reflux and DGER profile. No correlation was found between DeMeester score and fraction time of bilirubin abs >0.14 ( P = 0.3109). Fraction time of pH 0. 14 in supine position were significantly higher than that in upright position (P 0. 14 and score of reflux symptoms (P >0. 05 ) ,while positive correlation was significant among DeMeester score, fraction time of abs>0.14 and score of reflux esophagitis(P<0.05). Conclusion Acid reflux and DGER is common pattern after esophagectomy for cancer. Acid reflux and DGER occur simultaneously in the majority of the reflux episodes. The simultaneous acid reflux and DGER is responsible for the severity of injury of esophageal mucosa. The extent of both acid reflux and DGER is influenced by change of body position. Combined ambulatory twenty-four hour pH and spectrometric bilirubin monitoring DGER is useful of analysis of the pattern of reflux and the effect of injury for the esophageal mucosa by acid and duodenal contents. Key words: Esophageal neoplasm Postoperative complications;  Gastroesophageal reflux Duodenogastric reflux;  Esophagitis, peptic