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Clinical significance of hiatal hernia in the development of gastroesophageal reflux after distal gastrectomy for cancer of the stomach.
J Gastroenterol Hepatol. 2006 Jul; 21(7):1103-7.JG

Abstract

BACKGROUND AND AIMS

The relationship between gastroesophageal reflux disease and sliding hernia is controversial, especially following distal partial gastrectomy in patients with gastric cancer. The aim of this study was to examine the relationship between gastroesophageal reflux disease and sliding hernia of the esophagus after distal gastrectomy using the gastroesophageal scintigraphy and endoscopy.

METHODS

Forty-five distal gastrectomy patients diagnosed with cancer of the stomach were studied. Twenty-five patients presented with reflux symptoms, such as heartburn and/or regurgitation and 20 patients exhibited no reflux symptoms. All of the patients were examined by gastroesophageal scintigraphy and their reflux indices were determined. Thirty-eight of the patients underwent upper endoscopy and both sliding hernias and reflux symptoms were classified as mild or severe.

RESULTS

Sliding hernias were diagnosed in all of the subjects and 65.8% of the patients exhibited reflux symptoms. Evidence of endoscopic esophagitis was noted in only 39.5% of the patients. The reflux indices for the mild and severe hernia groups were 5.03 +/- 2.2 and 10.3 +/- 6.4, respectively (P < 0.05). More severely symptomatic esophagitis was prevalent in the severe hernia group in comparison to the mild group (P < 0.05).

CONCLUSION

The results suggest that the onset of gastroesophageal reflux after distal gastrectomy is induced by the surgical procedures and that hiatal hernia may be an important factor in the etiology of reflux esophagitis.

Authors+Show Affiliations

The Second Department of Surgery, Hyogo College of Medicine, Hyogo, Japan. fujiwa2s@hyo-med.ac.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

16824060

Citation

Fujiwara, Yoshinori, et al. "Clinical Significance of Hiatal Hernia in the Development of Gastroesophageal Reflux After Distal Gastrectomy for Cancer of the Stomach." Journal of Gastroenterology and Hepatology, vol. 21, no. 7, 2006, pp. 1103-7.
Fujiwara Y, Nakao K, Inoue T, et al. Clinical significance of hiatal hernia in the development of gastroesophageal reflux after distal gastrectomy for cancer of the stomach. J Gastroenterol Hepatol. 2006;21(7):1103-7.
Fujiwara, Y., Nakao, K., Inoue, T., Koishi, K., Nishio, Y., Yagyu, R., Nakagawa, K., & Yamamura, T. (2006). Clinical significance of hiatal hernia in the development of gastroesophageal reflux after distal gastrectomy for cancer of the stomach. Journal of Gastroenterology and Hepatology, 21(7), 1103-7.
Fujiwara Y, et al. Clinical Significance of Hiatal Hernia in the Development of Gastroesophageal Reflux After Distal Gastrectomy for Cancer of the Stomach. J Gastroenterol Hepatol. 2006;21(7):1103-7. PubMed PMID: 16824060.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical significance of hiatal hernia in the development of gastroesophageal reflux after distal gastrectomy for cancer of the stomach. AU - Fujiwara,Yoshinori, AU - Nakao,Koji, AU - Inoue,Takashi, AU - Koishi,Kenji, AU - Nishio,Yoshimasa, AU - Yagyu,Ryuichirou, AU - Nakagawa,Kazuhiko, AU - Yamamura,Takehira, PY - 2006/7/11/pubmed PY - 2006/11/15/medline PY - 2006/7/11/entrez SP - 1103 EP - 7 JF - Journal of gastroenterology and hepatology JO - J Gastroenterol Hepatol VL - 21 IS - 7 N2 - BACKGROUND AND AIMS: The relationship between gastroesophageal reflux disease and sliding hernia is controversial, especially following distal partial gastrectomy in patients with gastric cancer. The aim of this study was to examine the relationship between gastroesophageal reflux disease and sliding hernia of the esophagus after distal gastrectomy using the gastroesophageal scintigraphy and endoscopy. METHODS: Forty-five distal gastrectomy patients diagnosed with cancer of the stomach were studied. Twenty-five patients presented with reflux symptoms, such as heartburn and/or regurgitation and 20 patients exhibited no reflux symptoms. All of the patients were examined by gastroesophageal scintigraphy and their reflux indices were determined. Thirty-eight of the patients underwent upper endoscopy and both sliding hernias and reflux symptoms were classified as mild or severe. RESULTS: Sliding hernias were diagnosed in all of the subjects and 65.8% of the patients exhibited reflux symptoms. Evidence of endoscopic esophagitis was noted in only 39.5% of the patients. The reflux indices for the mild and severe hernia groups were 5.03 +/- 2.2 and 10.3 +/- 6.4, respectively (P < 0.05). More severely symptomatic esophagitis was prevalent in the severe hernia group in comparison to the mild group (P < 0.05). CONCLUSION: The results suggest that the onset of gastroesophageal reflux after distal gastrectomy is induced by the surgical procedures and that hiatal hernia may be an important factor in the etiology of reflux esophagitis. SN - 0815-9319 UR - https://www.unboundmedicine.com/medline/citation/16824060/Clinical_significance_of_hiatal_hernia_in_the_development_of_gastroesophageal_reflux_after_distal_gastrectomy_for_cancer_of_the_stomach_ L2 - https://doi.org/10.1111/j.1440-1746.2006.04135.x DB - PRIME DP - Unbound Medicine ER -