Roux-en-Y loop for gastro-esophageal reflux after esophagectomy with gastric pull-up for esophageal cancer - 16/11/21
Bienvenue sur EM-consulte, la référence des professionnels de santé.
Article gratuit.
Connectez-vous pour en bénéficier!
Highlights |
• | Many patients suffer from bilio-digestive reflux after oesophagectomy for cancer, which can have a significant impact on their quality of life. |
• | Roux-en-Y loop (RY) is a simple surgical solution for patients suffering from gastroesophageal reflux after oesophagectomy. |
• | No gastric pull-up necrosis occurred after RY procedure. |
• | Quality of life was considered as good for the majority of patients. |
Abstract |
Background |
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.
Methods |
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).
Results |
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 conduit 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.
Conclusion |
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.
Le texte complet de cet article est disponible en PDF.Keywords : Esophagectomy, Reflux, Roux-en-Y loop, Quality of life
Plan
| Conflict of interest: no conflict to declare |
Vol 4
Article 100027- décembre 2021 Retour au numéro
Article précédent
- A day in the life…of a surgeon
- Charles Sabbagh, Patricio B Lynn
- Treatment of acute appendicitis in France by type of hospital: Patient profiles are different but practices and results are the same, a prospective cohort study of 1241 patients
- Sandrine Barbois, Olivier Gaget, Jean-louis Quesada, Alison Foote, Marie-Hélène Laverriere, Julio Abba, Bérénice Charrière, Jean-Robert Nzamushe, Karine Pautrat, Virianne Tan, Jean-Marc Regimbeau, Emeric Abet, Joelle Dubois, Emilie Lermite, Guillaume Passot, François Mauvais, Sharmini Varatharajah, Thierry Bensignor, Isabelle Pirlet, Astrid Herrero, Romain Riboud, Benjamin Blanc, Olivier Monneuse, Aude Merdrignac, Hamida Mechaoui, Xavier Briennon, Damien Massalou, Vincent Dubuisson, Nathan Moreno-Lopez, Lilian Schwarz, Jérôme Atger, Aurélie Vuagniaux, Virginie Pichot-Delahaye, Lala Julien Rasata, Samer Al Mustafa, Frédéric Villar, Smail Allaoua, Jean-Baptiste Putinier, Zaher Lakkis, Pierre-Yves Bouteloup, Jean-Yves Malgoire, Muriel Mathonnet, François Varlet, Aurélien Scalabre, Didier Mutter, Julien Frandon, Fatah Tidadini, Catherine Arvieux, APPEA Project Group
Bienvenue sur EM-consulte, la référence des professionnels de santé.