Research Report
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World J Gastroenterol. Dec 14, 2014; 20(46): 17434-17438
Published online Dec 14, 2014. doi: 10.3748/wjg.v20.i46.17434
Oesophageal flap valvuloplasty and wrapping suturing prevent gastrooesophageal reflux disease in dogs after oesophageal anastomosis
Ji-Gang Dai, Quan-Xing Liu, Xu-Feng Den, Jia-Xin Min
Ji-Gang Dai, Quan-Xing Liu, Jia-Xin Min, Xu-Feng Deng, Department of Thoracic Surgery, Xinqiao Hospital, the Third Military Medical University, Chongqing 400037, China
Author contributions: Dai JG contributed substantially to study conception and design and gave final approval of the version to be published; Liu QX contributed to analysis and interpretation of all the data and drafted the article; Deng XF and Min JX revised the article critically for important intellectual content.
Correspondence to: Jia-Xin Min, MD, Department of Thoracic Surgery, Xinqiao Hospital, the Third Military Medical University, Xinqiao Street Shapingba District, Chongqing 400037, China. daijigang400037@163.com
Telephone: + 86-23-68774724 Fax: +86-23-68774724
Received: March 8, 2014
Revised: August 16, 2014
Accepted: September 18, 2014
Published online: December 14, 2014
Processing time: 285 Days and 7.5 Hours
Abstract

AIM: To examine the efficiency of oesophageal flap valvuloplasty and wrapping suturing technique in decreasing the rate of postoperative gastrooesophageal reflux disease in a dog model.

METHODS: We operated on 10 dogs in this study. First, we resected a 5-cm portion of the distal oesophagus and then restored the continuity of the oesophageal and gastric walls by end-to-end anastomosis. A group of five dogs was subjected to the oesophageal flap valvuloplasty and wrapping suturing technique, whereas another group (control) of five dogs was subjected to the stapling technique after oesophagectomy. The symptom of gastrooesophageal reflux was recorded by 24-h pH oesophageal monitoring. Endoscopy and barium swallow examination were performed on all dogs. Anastomotic leakage was observed by X-ray imaging, whereas benign anastomotic stricture and mucosal damage were observed by endoscopy.

RESULTS: None of the 10 dogs experienced anastomotic leakage after oesophagectomy. Four dogs in the new technology group resumed regular feeding, whereas only two of the dogs in the control group tolerated solid food intake. pH monitoring demonstrated that 25% of the dogs in the experimental group exhibited reflux and that none had mucosal damage consistent with reflux. Conversely, both reflux and mucosal damage were observed in all dogs in the control group.

CONCLUSION: The oesophageal flap valvuloplasty and wrapping suturing technique can improve the postoperative quality of life through the long-term elimination of reflux oesophagitis and decreased stricture formation after primary oesophageal anastomosis.

Keywords: Oesophageal anastomosis; Oesophagectomy; Gastrooesophageal reflux

Core tip: This study describes the use of the oesophageal flap valvuloplasty and wrapping suturing technique to decrease the rate of postoperative gastrooesophageal reflux disease in a dog model after oesophagectomy. None of the 10 dogs experienced anastomotic leakage after oesophagectomy. Four dogs in the new technology group resumed regular feeding, whereas only two of the dogs in the control group tolerated solid food intake. pH monitoring demonstrated that 25% of the dogs in the experimental group exhibited reflux and that none had mucosal damage consistent with reflux. This technique may provide a good alternative method for preventing gastrooesophageal reflux after anastomosis following oesophagogastrectomy for oesophageal cancer.