Twenty-four-hour pH monitoring of gastric conduit in post-esophagectomy patients: correlation with clinical and endoscopic parameters in a prospective cohort study from India

Esophagectomy for malignancy leads to decreased gastric conduit acidity due to bilateral vagotomy and fundic gland area reduction. However, reflux symptoms occur. The changes in pH of gastric conduit and esophageal remnant post-esophagectomy were studied and correlated clinically, endoscopically and...

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Published in:Journal of minimally invasive surgery Vol. 28; no. 2; pp. 81 - 88
Main Authors: Jain, Vishu, Varshney, Vaibhav Kumar, Soni, Subhash Chandra, Selvakumar, B, Varshney, Peeyush, Agarwal, Lokesh, Agarwal, Ashish, Birda, Chhagan Lal
Format: Journal Article
Language:English
Published: Korea (South) The Korean Society of Endo-Laparoscopic & Robotic Surgery 15.06.2025
대한내시경로봇외과학회
Subjects:
esophagectomy
gastroesophageal reflux
hydrogen-ion concentration
Original
stomach
일반외과학
Gastroesophageal reflux
Esophagectomy
Stomach
Hydrogen-ion concentration
ISSN:2234-778X, 2234-5248, 2234-5248
Online Access:Get full text
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Summary:Esophagectomy for malignancy leads to decreased gastric conduit acidity due to bilateral vagotomy and fundic gland area reduction. However, reflux symptoms occur. The changes in pH of gastric conduit and esophageal remnant post-esophagectomy were studied and correlated clinically, endoscopically and with positivity. We studied 20 patients prospectively undergoing esophagectomy for malignancy from January 2022 to December 2023. The patients underwent pre- and postoperative clinical assessment, 24-hour pH monitoring, and esophagoduodenoscopy with testing and analysis. Postoperatively, the total percent (%) time pH <4 was nonsignificantly increased to 17.95% ( = 0.754) in the esophageal remnant and significantly decreased to 53.5% ( = 0.012) in the stomach. Postoperatively, the -positive patients had a non-significantly higher total % time pH <4 in the esophageal remnant than -negative patients (29.47 ± 33.54 vs. 6.44 ± 11.58, = 0.064) and slightly lower total % time pH <4 in the stomach (53.30 ± 46.08 vs. 53.71 ± 31.20, = 0.982). The total % time pH <4 in the gastric conduit was significantly correlated with the esophageal remnant ( = 0.002), showing a correlation coefficient of 0.629. There is a significant increase in gastric conduit pH post-esophagectomy with increased exposure to the esophageal remnant mucosa proportional to gastric acidity. infection does not affect gastric aciditiy and acid reflux after esophagectomy.
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ISSN:2234-778X
2234-5248
2234-5248
DOI:10.7602/jmis.2025.28.2.81