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Prevalence and risk factors of reflux after esophagectomy for esophageal cancer.

ABSTRACT: Background:Reflux symptoms including various extra-esophageal manifestations are commonly reported after esophagectomy. However, the intensity and presentation of reflux are both diverse and variable by patients. In this study we assessed reflux symptoms using the reflux symptom index (RSI) questionnaire in patients who underwent esophagectomy for esophageal cancer to order to identify the prevalence of significant reflux and its risk factors. Methods:From April 2017 to July 2017, we investigated patients who underwent esophagectomy for esophageal cancer. The severity of reflux was evaluated with a self-administered nine-item outcomes instrument (score: 0 to 5). An RSI score ?13 was considered significant reflux. Multivariable analysis was conducted to identify risk factors. Results:A total of 151 patients was included (mean age, 64.1±8.8 years; male, n=136, 90.1%). The median time after esophagectomy was 22.6 months. The question regarding heartburn, chest pain, indigestion, or acid coming up was most frequently responded (n=104, 68.9%) with 41 (27.2%) patients presenting significant reflux (mean RSI score, 19.9±6.3). Time after esophagectomy <2 years, vocal cord palsy, retrosternal route of reconstruction, and postoperative weight loss were identified as significant risk factors for RSI ?13 in the multi-variable analysis. Conclusions:Reflux related symptoms including extra-esophageal manifestations were common. Our study revealed that short duration after esophagectomy, vocal cord palsy, retrosternal route of reconstruction, and postoperative weight loss were significant associated factors for reflux symptom after esophagectomy.

SUBMITTER: Park S

PROVIDER: S-EPMC7139076 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Prevalence and risk factors of reflux after esophagectomy for esophageal cancer.

Park Samina S Kang Chang Hyun CH Lee Hyun Joo HJ Park In Kyu IK Kim Young Tae YT

Journal of thoracic disease 20200301 3

<h4>Background</h4>Reflux symptoms including various extra-esophageal manifestations are commonly reported after esophagectomy. However, the intensity and presentation of reflux are both diverse and variable by patients. In this study we assessed reflux symptoms using the reflux symptom index (RSI) questionnaire in patients who underwent esophagectomy for esophageal cancer to order to identify the prevalence of significant reflux and its risk factors.<h4>Methods</h4>From April 2017 to July 2017, ...[more]

PMID: 32274121

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Project description:Background:Robot-assisted minimally invasive esophagectomy (RAMIE) reduces postoperative respiratory complications and enables meticulous mediastinal lymphadenectomy. However, whether adding a robotic abdominal procedure to a robotic thoracic procedure can result in better outcomes is unclear. We examined outcomes after total-RAMIE (T-RAMIE) and compared them with the outcomes after hybrid-RAMIE (H-RAMIE). Methods:Total of 227 patients who underwent robotic esophagectomy for esophageal cancer were included. T-RAMIE was defined as esophagectomy performed robotically in both the thoracic and abdominal cavities. Laparotomy was used instead of the robotic procedure in H-RAMIE. T-RAMIE was performed in 144 patients (63.4%), and propensity score matching produced 49 matched pairs from each group. Early and long-term clinical outcomes between the two groups were compared. Results:T-RAMIE was mostly performed for upper or mid-thoracic squamous cell carcinoma (n=119, 82.6%) and cervical anastomosis, and three-field lymphadenectomy was performed in 113 (78.5%) and 54 (37.5%) patients, respectively. One laparotomy conversion was necessary because of severe obesity. The propensity-matched analysis demonstrated that T-RAMIE showed a comparable 90-day mortality rate with H-RAMIE (0% vs. 6.1%, P=0.083). The incidence rates of total (63.3% vs. 63.3%; P=1.000), abdominal (8.2% vs. 14.3%; P=0.366), and respiratory complications (10.2% vs. 10.2%; P=1.000) were not different between two groups. The number of harvested abdominal lymph nodes was similar (12.4±9.0 vs. 12.3±8.9; P=0.992). Median follow-up duration for T-RAMIE and H-RAMIE was 16.3 and 23.5 months, respectively. Two-year overall survival rate (86.2% in T-RAMIE vs. 77.6% in H-RAMIE; P=0.150) and recurrence-free survival (76.6% in T-RAMIE vs. 62.2% in H-RAMIE; P=0.280) were comparable between the two groups. Conclusions:In this matched analysis, T-RAMIE and H-RAMIE showed comparable early outcomes and long-term survival. The low tendencies of early mortality and conversion rate of T-RAMIE suggest that it might be a safe alternative to open stomach mobilization and abdominal lymphadenectomy.

Dataset Information

Prevalence and risk factors of reflux after esophagectomy for esophageal cancer.

Publications

Prevalence and risk factors of reflux after esophagectomy for esophageal cancer.

Similar Datasets

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