Objective: To investigate the motility function of remnant esophagus and stomach, and the gastroesophageal reflux after esophagectomy and esophagogastric anastomosis following esophageal bed.
Methods: Esophageal manometry and 24-hour pH monitoring were performed in 10 healthy volunteers and 20 patients who underwent esophagectomy and esophagogastric anastomosis through esophageal bed as a treatment for mid-esophageal carcinoma. These 20 patients, received examinations within 3 to 6 months after operations, were defined as study group, and 10 healthy volunteers as control group.
Results: (1) All the pH monitoring indexes in study group were significantly higher than those in control group (P<0.01). (2) Rest pressures of stomach, remnant esophagus and upper esophageal sphincter significantly increased in comparison with control group(P<0.01). (3) The contracting pressure, amplitude of primary peristalsis and amplitude of swallow peristalsis of remnant esophagus were reduced as compared to control group(P<0.01). (4) The contraction pressure of upper esophageal sphincter was obviously higher than that of control group (P<0.01). (5) There were no significant differences among stomach rest pressure, anastomosis rest pressure and remnant esophagus rest pressure in study group (F=3.08, P>0.05).
Conclusion: After esophagectomy and esophagogastric anastomosis through esophageal bed in upper aortic site, the peristalsis function of remnant esophagus is poor, the function of acid clearance is reduced, no high pressure zone at the anastomosis orifice is found, the anastomosis orifice has no anti-reflux effect, and gastroesophageal reflux exists in the postoperative patients prevalently.