Few strategies are described to manage gastroesophageal reflux after esophagectomy with gastric pull-up. Our study focuses on feasibility, long term efficacy on reflux symptoms and impact on quality of life after Roux-en-Y loop (RY) after esophagectomy and gastric pull-up for cancer in patients suffering from gastro-esophageal reflux.

We studied all consecutive patients who received, between 2010 and 2019, RY for reflux after esophagectomy. Postoperative morbimortality was evaluated from a prospectively maintained database. Quality of life was assessed by the GIQLI validated questionnaire (rated on 144).

During this period, 9 patients had a RY. All had a severe clinical manifestation of GE reflux with failure of medical treatment. Median length of hospitalization was 8 (6-34) days. Postoperative morbidity and mortality rates were 33% and 0%, respectively. No patients experienced transplant necrosis. The median follow-up was 17 (5-51) months. The mean GIQLI score after intervention was 94.5 (+/-24.3). Four patients had a GIQLI comparable to general population after reflux surgery (110+/-23). Four patients no longer experienced heartburn, six patient only rarely experienced regurgitation. The mean Visick score was 2.1, and only 1 patient had no symptomatology improvement. Three patients considered a complete regression of the symptomatology thanks to this intervention.

Roux-en-Y loop after esophagectomy and gastric pull-up is a safe technique for the management of disabling reflux, without affecting the gastric viability in our experiment. This technique allows a good regression of symptoms related to reflux for the majority of patients and a satisfying quality of life.