{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,2,14]],"date-time":"2024-02-14T12:21:14Z","timestamp":1707913274476},"reference-count":21,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2004,12,9]],"date-time":"2004-12-09T00:00:00Z","timestamp":1102550400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2005,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The precise mechanisms that cause gastroesophageal reflux after distal gastrectomy remain unclear. We analyzed the endoscopic findings of the cardia and the position of the remnant stomach, which are related to gastroesophageal reflux. We retrospectively examined the records of 45 patients with Billroth I (B\u2010I) and 39 patients with Roux\u2010en\u2010Y (R\u2010Y) procedure for gastric cancer. Esophagitis was evaluated by the Los Angeles (LA) classification. The endoscopic findings of hiatus hernia were classified according to the criteria of the Keio Cancer Detection Center form (K\u2010form). The valvular appearance of the cardia was classified according to V\u2010grades. The height of the remnant stomach was measured on computed tomography scans. The postoperative findings of esophagitis in the B\u2010I group were significantly worse than the preoperative findings, but no significant change was observed in the R\u2010Y group. The postoperative V\u2010grades and K\u2010forrn findings in the B\u2010I group were worse than their preoperative findings. In the R\u2010Y group, however, there was no significant change in the V\u2010grades or K\u2010form findings. In addition, the height of the remnant stomach was significantly higher in the B\u2010I group than in the R\u2010Y group. This study suggested that an aggravated cardia is associated with the B\u2010I procedure and that the position of the remnant stomach may therefore play an important role in the occurrence of postoperative reflux esophagitis. In contrast, the R\u2010Y operation was shown to preserve the cardia and the position of the remnant stomach better. As a result, R\u2010Y might help prevent not only duodenogastric reflux but also gastroesophageal reflux.<\/jats:p>","DOI":"10.1007\/s00268-004-7415-3","type":"journal-article","created":{"date-parts":[[2004,12,14]],"date-time":"2004-12-14T02:41:00Z","timestamp":1102992060000},"page":"50-57","source":"Crossref","is-referenced-by-count":13,"title":["Morphologic Analysis of Gastroesophageal Reflux Diseases in Patients after Distal Gastrectomy"],"prefix":"10.1002","volume":"29","author":[{"given":"Tsunehiro","family":"Takahashi","sequence":"first","affiliation":[{"name":"Department of Surgery Keio University School of Medicine 35 Shinanomachi 160\u20108582 Shinjuku\u2010ku Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masashi","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Surgery Keio University School of Medicine 35 Shinanomachi 160\u20108582 Shinjuku\u2010ku Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetsuro","family":"Kubota","sequence":"additional","affiliation":[{"name":"Department of Surgery Keio University School of Medicine 35 Shinanomachi 160\u20108582 Shinjuku\u2010ku Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshihide","family":"Otani","sequence":"additional","affiliation":[{"name":"Department of Surgery Keio University School of Medicine 35 Shinanomachi 160\u20108582 Shinjuku\u2010ku Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshiro","family":"Saikawa","sequence":"additional","affiliation":[{"name":"Department of Surgery Keio University School of Medicine 35 Shinanomachi 160\u20108582 Shinjuku\u2010ku Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideki","family":"Ishikawa","sequence":"additional","affiliation":[{"name":"Department of Surgery Keio University School of Medicine 35 Shinanomachi 160\u20108582 Shinjuku\u2010ku Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuhiro","family":"Suganuma","sequence":"additional","affiliation":[{"name":"Department of Surgery Keio University School of Medicine 35 Shinanomachi 160\u20108582 Shinjuku\u2010ku Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukako","family":"Akatsu","sequence":"additional","affiliation":[{"name":"Department of Surgery Keio University School of Medicine 35 Shinanomachi 160\u20108582 Shinjuku\u2010ku Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koichiro","family":"Kumai","sequence":"additional","affiliation":[{"name":"Center for Diagnostic and Therapeutic Endoscopy Keio University School of Medicine 35 Shinanomachi 160\u20108582 Shinjuku\u2010ku Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masaki","family":"Kitajima","sequence":"additional","affiliation":[{"name":"Department of Surgery Keio University School of Medicine 35 Shinanomachi 160\u20108582 Shinjuku\u2010ku Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2004,12,9]]},"reference":[{"key":"e_1_2_6_2_2","unstructured":"YoshidaM TsuyukiA KikuchiK et al.Reflux esophagitis after distal gastrectomy and endoscopic findings of the cardia. 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