[Functional evaluation of the intrathoracic stomach after esophagectomy for esophageal cancer]

Sixteen patients underwent evaluation of duodenogastric reflux and gastric function 1 to 7 years after esophagectomy, high intrathoracic anastomosis, and pyloric divulsion for esophageal cancer. Ten patients (62%) had either postoperative digestive symptoms or endoscopic mucosal lesions, cholescintigraphy demonstrated duodenogastric reflux in 11 cases (69%). No gastric motor activity was recorded on manometry. 24-hour pH gastric monitoring showed that the area under the curve less than 4 was significantly less than in controls (p = 0.0003). The results of the present study show that duodenogastric reflux is a common event after esophageal replacement with the stomach. The interaction between acid and alkaline secretions plays a role in the pathogenesis of mucosal lesions, and it may explain the partial failure of the current therapeutic strategies.