Ulcer in the gastric tube for esophageal replacement: A comparison of 12 esophageal cancer patients with or without postoperative radiotherapy

Background and Aims: Ulcer in the gastric tube for esophageal replacement, which was caused by peptic factors or postoperative radiotherapy (Rx), are occasionally reported. The aim of this study was to clarify the clinicopath ologic features of the ulcers in the gastric tube. Methods: In 62 patients with a reconstructed gastric tube, after esophagect omy for esophageal cancer, esophagogastroduodenoscopy was performed. Ulcers of the gastric tube were detected in 12 patients: six with postoperative R x and six without Rx. The 12 patients with gastric tube ulcers (GU-group) w ere reviewed and compared to the remaining 50 patients without ulcers of th e gastric tube (Control-group). Clinicopathologic features of gastric tube ulcers were compared between the patients with and without Rx. Results: There was no difference in any parameter between the patients of t he GU- and Control-groups. Comparing the patients of the GU-group with and without Rx, the ulcers of the gastric tube in the patients without Rx were frequently located in the lower part of the gastric tube (P = 0.067), detec ted in a later period after surgery (P = 0.055), associated with cervical e sophagitis (P = 0.03), and less associated with gastritis (P = 0.03). In th ree patients of the GU-group without Rx, Helicobacter pylori was detected i n the gastric tube. Two of the three patients had a history of peptic ulcer s before surgery, and had recurrence of the gastric tube ulcers. Conclusions: Gastric tube ulcers without postoperative Rx may have differen t characteristics compared to those induced by Rx. (C) 2001 Blackwell Scien ce Asia Pty Ltd.