Sniping “reflux esophagitis” Reflux esophagitis is one of the serious complications after pancreatic resection for esophageal cancer. 25-30% of patients with intrathoracic esophagogastric anastomosis have definite reflux esophagitis.
In the presence of non-surgical factors, the occurrence of reflux esophagitis is related to many physiological mechanisms, but post-surgical reflux esophagitis is clearly related to the disappearance of the anti-reflux barrier at the esophagogastric junction. Post-surgical patients may experience acid reflux, retrosternal pain, swallowing pain, burning sensation behind the sternum, which may be accompanied by vomiting blood or vomiting, etc. Although taking antacids, antibiotics, pro-gastric motility drugs, the effect is generally poor, which seriously affects The quality of life of patients is seriously affected and their mental burden is heavy.
Due to the use of anastomosis and improvement of surgical skills, anastomotic fistula and anastomotic stenosis have rarely occurred, the focus is on how to reduce postoperative gastric reflux of gastric juice and gastric contents, the method is to do the gastric fundus, pressure anastomosis, wide fissure and mucosa reduction. The normal esophagogastric junction has a large gastric fundus next to it, whose function is to compress the cardia by stacking gastric contents in the fundus after stomach feeding, which is one of the physiological mechanisms to prevent reflux. The function of the long thoracic stomach is not to store food and digestion but only to replace the esophageal channel, too much gastric mucosa is not conducive to long-term post-operative recovery, so timely adjustments were made during surgery to remove half of the stomach, leaving only the part that can be used as a channel, which greatly reduces the thoracic stomach in appearance and eliminates the unwanted gastric secretion, with excellent results after several months of recent follow-up.
For non-operative reflux esophagitis, the thoracic and cardiac surgeons led by Director Yao are also seeking methods other than medical and TCM treatment, such as laparoscopic fundoplication and artificial cardia placement, etc. It is believed that with their unremitting efforts, reflux esophagitis will eventually be overcome.