• Title/Summary/Keyword: 위식도 역류

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Assessment of the Quality of Esophago-gastric Anastomosis by Endoscopic Examination -Cervical Versus Intrathoracic Anastomosis- (내시경을 통한 식도-위 문합술의 질 평가-경부와 흉부 문합의 비교-)

  • Shim, Jae-Hoon;Kim, Hyun-Koo;Baek, Man-Jong;Kim, Hark-Jei;Choi, Young-Ho
    • Journal of Chest Surgery
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    • v.39 no.12 s.269
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    • pp.920-926
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    • 2006
  • Background: Mortality and morbidity of anastomotic complications after esophagectomy have gradually decreased in recent years. However, swallowing difficulties and reflux symptoms after esophagogastrostomy continue to be a burden jeopardizing the quality of life. In the present study, we evaluated the quality of esophagogastrostomy by analyzing anastomotic stenosis and reflux esophagitis. Material and Method: A retrospective analysis was made in 74 patients who underwent esophagogastrostomy after esophagectomy by one surgeon between January 1995 and December 2004. 53 patients of them received endoscopic examination during follow-up($29{\pm}23.6$ months, range $5{\sim}111$ months). Reflux esophagitis and stenosis at anastomostic site were analyzed according to the techniques and locations of esophagogastrostomy. Result: The median age at the time of repair was $60.3{\pm}8.87$ years(range $39{\sim}81$ years). 23 patients received a hand-sewn esophagogastric anastomosis and 30 patients a circular stapled one. There was no significant statistical difference in terms of anastomotic stenosis(p=0.64) and reflux esophagitis(p=0.41) between the two groups. Cervical anastomosis was peformed in 26 patients and intrathoracic anastomosis in 27 patients. No significant statistical difference in anastomotic stenosis between the two groups was found(p=0.44), but reflux esophagitis was noted in 3 patients in the cervical anastomosis group and 14 patients in the intrathoracic anastomosis group(p=0.003). Conclusion: Cervical anastomosis was supposed to have a better quality of esophagogastrostomy by lowering the risk of reflux esophagitis. In the future, the comprehensive study including a patient's subjective symptom and Barrett's metaplasia should be performed in larger cases.

Comparison between 24 hr pH Monitoring and Esophageal Scintigrapy in Children Presenting with Gastroesophageal Reflux Symptoms (식도 동위 원소 검사와 24시간 식도 pH 검사와의 비교 연구)

  • Wi, Ho Sung;Kim, Yong Joo;Seol, In Joon;Choi, Yun Young
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.2
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    • pp.163-169
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    • 2004
  • Purpose: Many diagnostic modalities have been used for diagnosis of gastroesophageal reflux disease (GERD). Feeding materials during esophageal pH monitoring may interfere the result of examination and esophageal pH monitoring can not diagnose GER in case of alkaline reflux. The purpose of our study is to evaluate whether scintigraphy can substitiute 24 hr pH monitoring in children with GERD. Methods: From March 2002 to June 2003, 23 patients (12 boys and 11 girls, mean age 27 months) who have been admitted to Hanyang University Hospital presented with GER symptoms (recurrent vomiting, cough, chest pain, irritability) were included in the study. Scintigraphy and 24 hr pH monitoring were performed in all patients. Results: Six out of the 23 patients (26.1%) had evidence of GER on 24 hr pH monitoring, whereas nine of 23 patients (39.2%) exhibited GER by scintigraphy. Two out of the 23 patients could not be tested because of irritability. Three (14.3%) patients had evidence of GER on both 24 hr pH monitoring and scintigraphy, three (14.3%) patients on only 24 hr pH monitoring, six (28.6%) patients on only scintigraphy, and nine (42.9%) patients had no evidence of GER on both methods. No correlation was observed between 24 hr pH monitoring and scintigraphic results by Fisher's exact test (p=0.523) or Kendal's tau (t=0.678). Conclusion: The results of this study demonstrated that there was no correlation between 24 hr pH monitoring and scintigraphy. Therefore these modalities could be used as complementary tests to diagnose GERD.

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Gastroesophageal Reflux in Peptic Ulcer Patients (소화성 궤양 환자에서 위식도 역류)

  • Suh, Joong-San;Kim, Jong-Hyeok;Chung, Moon-Kwan
    • Journal of Yeungnam Medical Science
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    • v.16 no.2
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    • pp.302-308
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    • 1999
  • Background: It is well known fact to the patients of duodenal ulcer that their condition is frequently accompanied with reflux esophagitis. Therefore this condition is called an "acid-related disorder" because it is commonly associated with increased acidity. But there has been disputes on the effect of Helicobacter pylori eradication in these two conditions and whether H. pylori infection may have a protective role in reflux esophagitis. Only few reports have dealt with the prevalence of reflux esophagitis and gastroesophageal reflux in patients with peptic ulcer The aim of this study is to estimate the prevalence of gastroesophageal reflux and to analyze the pattern of the pathologic reflux in peptic ulcer patients. Materials and Methods: The study population consisted of 57 patients with endoscopically confirmed duodenal and/or gastric ulcer who all underwent 24hr ambulatory esophageal pH monitoring. Results: The prevalance of gastroesophageal reflux in peptic ulcer patients was 54.2% and 54,5% in gastric ulcer, and 62.5% in duodenal ulcer, 50% in combined ulcer, respectively. The prevalence of gastroesophageal reflux in the control group was 22.7% Conclusion: We discovered significantly higher prevalence of gastroesophageal reflux in patients with peptic ulcer disease than in those without it. In conclusion, the presence or absence of gastroesophageal reflux must be considered in the setting of peptic ulcer disease management.

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Clinical Comparison of Complications Between Esophagogastrostomy and Jejunal Free Transfer After Resection of Thoracic Esophageal Cancer (흉부식도암 절제술 후 식도-위 문합술군과 유리공장이식술군간의 조기 합병증 비교)

  • 신호승;이재진;홍기우
    • Journal of Chest Surgery
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    • v.34 no.11
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    • pp.843-847
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    • 2001
  • Background: Replacement of the esophagus remains a challenge for surgeons involved in esophageal disease. From 1996 to 1999, a total of 27 patients with esophageal cancer underwent free jejunal transfer(12cases) or esophagogastrostomy(15cases). To determine the results such as leakage of anastomosis site, stenosis, reflux esophagitis and operation time, respiratory complications, etc. we reviewed the 4 years experiences. Material and method: Palliative bypass surgery or esophageal prosthesis and cancers of the pharyngoesophageal or esophagogastric junction were excluded in this study. Resection was usually peformed through right thoracotomy and anastomosis was made with EEA staplers in esophagogas-trstomy. In cases of jejunal free transfer, 6cases of proximal esophagojejunostomy were stapled anastomosed and remaining 6 cases and all distal site were hand-sewn anastomosed. All reconstruction was done through posteromediastinal route. Result: There were two mortalities from thoracic esophagogastrostomy and one from jeunal free transfer. Major and minor complications(anastomosis site leakage: 3 cases, graft failure: 2cases etc) occurred in 27 cases. In 15 thoracic esophagogastrostomy cases, 11 patients had mild to moderate reflux esophagitis and 5 patients incurred stricture of the anastomosis. Operation time was about 550$\pm$280 minutes in jejunal free transfer, and about 300$\pm$ 160 minutes in esophagogastromy patients. Conclusion: Post operative reflux esophagitis and dysphagia were more frequent in Ivor-Lewis operation group than jejunal free transfer group; however, respiratory complications and operation time were significantly longer in jejunal (roe transfer group(p<0.05). To minimize the incidence of postoperative reflux esophagitis and dysphagia, patient evaluation focused on jejunal free transfer surgery is better than esophagogastrostomy followed by adequate post operative care.

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Relationship Between Exercise Induced Asthma and Gastroesophageal Reflux (운동유발성 천식과 위식도역류와의 연관성)

  • Lee, Heung-Bum;Lee, Yang-Deok;Kim, Hyun-Chul;Lee, Yong-Chul;Lee, Soo-Teik;Rhee, Yang-Keun
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.2
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    • pp.203-209
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    • 2000
  • Background: Exercise is a very common precipitant of asthma. Bronche-constriction associated with exercise can occur in 75~90% of individuals with asthma The estimated prevalence(30~85%) of gastroesophageal reflux(GER) in patients with asthma is significantly higher than in general population. We performed pH monitoring during the exercise in order to evaluate whether exercise induced asthma(EIA) could be related to GER and acid reflux-induced esophagobronchial reflex-mediated bronchospasm might be a factor for EIA. Method: Following an overnight fast, 18 patients with a suspected EIA(6 men, 12 women) were studied. Monitoring of intraesophageal pH, ECG and spirometry was done for 1 hour before treadmill exercise. After baseline monitoring, subjects underwent symptom-limited treadmill exercise with Bruce protocol and continuous monitoring for 60 min after exercise. Spirometry was done at baseline prior to exercise, and repeated every 10 min after full exercise for 60 min. Results: Exercise-induced bronchoconstriction was noted in 15 patients, who performed MBPT and 12 patients confirmed for bronchial asthma and 3 patients were diagnosed exercise-induced astham. Five of 15 EIA patients demonstrated a pathologic degree of GER. Conclusion: We suggest that GER may be one of pathophysiologic factors of EIA and evoke further concentration on the GER in the EIA patients.

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Factors Affecting Health Promotion Behaviors in Patients with Reflux Esophagitis (역류성 식도염 환자의 건강증진행위에 미치는 영향요인)

  • Yeo, Jae-Heon;Han, Suk-Jung
    • Journal of the Korea Convergence Society
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    • v.12 no.5
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    • pp.255-266
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    • 2021
  • This descriptive survey aimed to investigate the health promotion behaviors of patients with reflux esophagitis and identify the factors influencing it using the health promotion model. The survey was conducted with 178 outpatients diagnosed with reflux esophagitis at C university hospital. Data were analyzed by descriptive statistics, t-test, ANOVA, Pearson's correlation, and multiple regression using SPSS win ver 20. We found that alcohol consumption, BMI, perceived benefit, internal control level, and perceived health status of the patients are significant factors influencing health promotion behavior. The explanatory power was 49%. Therefore, this study is consistent with previous studies that elucidated that changing lifestyle behaviors and obesity control are necessary to alleviate reflux esophagitis. Based on these findings, we propose to develop and apply an educational program for evaluation.