Het functioneren van de buismaag na oesofagusresectie wegens carcinoom

- A retrospective study was made of the functional results of the tube stomach created in 80 patients after oesophageal resection because of carcinoma to restore the continuity. The study concerned patients who had survived the operation for longer than 18 months without indications of tumour recurrence or metastases and of whom clinical and endoscopical data of 3 months and one year after the operation were available.

The functional results of the tube stomach may be regarded as good because one year postoperatively 86 of the patients were classified as excellent or very good according to the modified Visick classification. Dumping (18), a sensation of fullness (26) and diarrhoea (28) were frequent complaints, occurring mostly soon after the operation. After one year these complaints are almost completely gone. Three months postoperatively, 19 of the patients had a stenosis of the anastomosis that required one or more dilatations. Reflux oesophagitis is the major late complication, leading to late stricture of the anastomosis. Reflux oesophagitis was encountered in 43 of the patients with an intrathoracic anastomosis and in only 6 of those with a cervical anastomosis; the difference is statistically significant. After one year, a stenosis due to reflux was encountered in four of the 30 patients (13) with an intrathoracic anastomosis and in only one of the 50 patients (2) with a cervical anastomosis.

These results show that from the functional point of view, as well, the stomach is a good substitution organ after oesophageal resection, provided the anastomosis is created in the neck.