P1.035. Postoperative Acid-Suppressive Therapy Duration and Risk Factor of Gastroesophageal Reflux Disease Following Subtotal Esophagectomy
TL;DR
Continuation of acid-suppressive therapy for at least one year after esophagectomy may help reduce the incidence of postoperative GERD, and the optimal duration of acid-suppressive therapy after esophagectomy remains unclear and requires further investigation.
Abstract
Benign Disease: Iatrogenic Esophageal Disease, Perforation and Postsurgical Complications Gastroesophageal reflux disease (GERD) after esophagectomy is an important complication that impairs postoperative quality of life (QOL). However, factors associated with the incidence of GERD, particularly the impact of acid-suppressive medication use, remain unclear. We retrospectively analyzed 106 patients who underwent esophagectomy for esophageal cancer at our institution between January 2013 and December 2022. GERD was defined as the presence of reflux symptoms persisting for more than three months postoperatively or endoscopic findings of GERD graded as Los Angeles classification grade A or higher. The associations between perioperative factors and the development of GERD were evaluated. Multivariable analysis using competing risk regression was used for analysis. During a median follow-up period of 52.1 months, the 3-year cumulative incidence of GERD was 34.3%. All patients received postoperative acid-suppressive therapy, with a median treatment duration of 33.8 months (0.83–105.7). Sixteen patients discontinued therapy within one year, whereas 90 patients continued therapy for ≥1 year. No significant difference in GERD incidence was observed among medication types. Multivariable analysis demonstrated that discontinuation of acid-suppressive medication within one year after surgery was independently associated with the development of GERD. Sex, age, preoperative body mass index, Brinkman index, postoperative body weight change, anastomotic stricture, and recurrent laryngeal nerve palsy were not significantly associated with GERD. Continuation of acid-suppressive therapy for at least one year after esophagectomy may help reduce the incidence of postoperative GERD. The optimal duration of acid-suppressive therapy after esophagectomy remains unclear and requires further investigation.