Abstract | BACKGROUND: AIM: To analyze late clinical, endoscopic, and pathologic findings in the esophageal stump (ES) mucosa after subtotal esophagectomy in patients treated for advanced chagasic achalasia. METHODS: 101 patients submitted to esophagectomy and cervical gastroplasty were followed-up prospectively for a mean of 10.5 +/- 8.8 years. All patients underwent clinical, endoscopic and histopathological evaluation every 2 years. Gastric acid secretion was also assessed. RESULTS: The incidence of esophagitis in the esophageal stump (45.9% at 1 year; 71.9% at 5 years, and 70.0% at 10 years follow-up); gastritis in the transposed stomach (20.4% at 1 year, 31.0% at 5 years, and 40.0% at 10 or more years follow-up), and the occurrence of ectopic columnar metaplasia and Barrett's Esophagus in the ES (none until 1 year; 10.9% between 1 and 5 years; 29.5% between 5 and 10 years; and 57.5% at 10 or more years follow-up), all rose over time. Gastric acid secretion returns to its preoperative values 4 years postoperatively. Esophageal stump cancer was detected in the setting of chronic esophagitis in five patients: three squamous cell carcinomas and two adenocarcinomas. CONCLUSION:
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Authors | Julio Rafael Mariano da Rocha, Ulysses Ribeiro Jr, Rubens A A Sallum, Sérgio Szachnowicz, Ivan Cecconello |
Journal | Annals of surgical oncology
(Ann Surg Oncol)
Vol. 15
Issue 10
Pg. 2903-9
(Oct 2008)
ISSN: 1534-4681 [Electronic] United States |
PMID | 18618179
(Publication Type: Journal Article)
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Topics |
- Adenocarcinoma
(etiology, pathology, surgery)
- Adolescent
- Adult
- Aged
- Barrett Esophagus
(etiology, pathology, surgery)
- Carcinoma, Squamous Cell
(etiology, pathology, surgery)
- Duodenogastric Reflux
(complications, pathology, surgery)
- Esophageal Achalasia
(surgery)
- Esophageal Neoplasms
(etiology, surgery)
- Esophagectomy
- Esophagitis
(etiology, surgery)
- Female
- Follow-Up Studies
- Gastroesophageal Reflux
(pathology, surgery)
- Gastroplasty
- Humans
- Male
- Middle Aged
- Postoperative Complications
- Prognosis
- Prospective Studies
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