caa a22 4500 606204253 CHVBK 20210128101001.0 cr unu---uuuuu 210128e20150101xx s 000 0 eng 10.1007/s10388-014-0453-5 doi (NATIONALLICENCE)springer-10.1007/s10388-014-0453-5 Gastric tube ulcer after esophagectomy [Elektronische Daten] [Naoki Mori, Hiromasa Fujita, Toshiaki Tanaka, Satoru Matono, Kohei Nishimura, Haruhiro Hino, Kazuo Shirouzu, Shou Komukai, Takashi Yanagawa] Background: An ulcer occasionally develops in the gastric tube as an esophageal substitute after esophagectomy. The aim of the present study was to investigate the risk factors for a gastric tube ulcer. Methods: We reviewed the medical records of all 826 patients who underwent esophageal reconstruction using a gastric tube following esophagectomy, in Kurume University Hospital between 1985 and 2010. Potential risk factors for a gastric tube ulcer were investigated by comparing the clinical characteristics between patients with a gastric tube ulcer and those without, using a multivariate logistic regression model. Results: Among the 826 patients, 30 patients (3.6%) developed a gastric tube ulcer. In 19 cases without any signs or symptoms, the ulcer was found using upper endoscopy. In the other 11 patients, there were symptoms including hematemesis, chest pain, and/or abdominal pain. In 3 cases, the patient developed a severe complication from the ulceration such as perforation. Of these 3 cases, one patient died of massive bleeding from the left brachiocephalic vein. The multivariate analysis revealed that (1) a past history of a peptic ulcer, and (2) the period of treatment (meaning the more recent period after the introduction of systematic prevention and treatment for a gastric tube ulcer) were the only two risk factors for a gastric tube ulcer (p<0.0001, and p=0.033, respectively). Conclusions: Systematic prevention and treatment for a gastric tube ulcer including follow-up endoscopy, proton pump inhibitors administration according to 24-h pH monitoring, eradication of H. pylori, and others may decrease the incidence of a gastric tube ulcer. In particular, for patients with a past history of a peptic ulcer, the subcutaneous route of esophageal reconstruction is recommended to prevent fatal complications. The Japan Esophageal Society and Springer Japan, 2014 Gastric tube ulcer nationallicence Esophagectomy nationallicence Risk factor nationallicence Mori Naoki Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, 830-0023, Kurume city, Fukuoka, Japan aut Fujita Hiromasa Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, 830-0023, Kurume city, Fukuoka, Japan aut Tanaka Toshiaki Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, 830-0023, Kurume city, Fukuoka, Japan aut Matono Satoru Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, 830-0023, Kurume city, Fukuoka, Japan aut Nishimura Kohei Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, 830-0023, Kurume city, Fukuoka, Japan aut Hino Haruhiro Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, 830-0023, Kurume city, Fukuoka, Japan aut Shirouzu Kazuo Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, 830-0023, Kurume city, Fukuoka, Japan aut Komukai Shou Biostatistics Center, Kurume University, 830-0023, Kurume city, Fukuoka, Japan aut Yanagawa Takashi Biostatistics Center, Kurume University, 830-0023, Kurume city, Fukuoka, Japan aut Esophagus Springer Japan 12/1(2015-01-01), 44-49 1612-9059 12:1<44 2015 12 10388 https://doi.org/10.1007/s10388-014-0453-5 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10388-014-0453-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Mori Naoki Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, 830-0023, Kurume city, Fukuoka, Japan aut NATIONALLICENCE 700 1- Fujita Hiromasa Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, 830-0023, Kurume city, Fukuoka, Japan aut NATIONALLICENCE 700 1- Tanaka Toshiaki Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, 830-0023, Kurume city, Fukuoka, Japan aut NATIONALLICENCE 700 1- Matono Satoru Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, 830-0023, Kurume city, Fukuoka, Japan aut NATIONALLICENCE 700 1- Nishimura Kohei Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, 830-0023, Kurume city, Fukuoka, Japan aut NATIONALLICENCE 700 1- Hino Haruhiro Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, 830-0023, Kurume city, Fukuoka, Japan aut NATIONALLICENCE 700 1- Shirouzu Kazuo Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, 830-0023, Kurume city, Fukuoka, Japan aut NATIONALLICENCE 700 1- Komukai Shou Biostatistics Center, Kurume University, 830-0023, Kurume city, Fukuoka, Japan aut NATIONALLICENCE 700 1- Yanagawa Takashi Biostatistics Center, Kurume University, 830-0023, Kurume city, Fukuoka, Japan aut NATIONALLICENCE 773 0- Esophagus Springer Japan 12/1(2015-01-01), 44-49 1612-9059 12:1<44 2015 12 10388