Gerdq问卷对食管癌术后胃食管反流病的诊断价值

Q4 Medicine Kurume Medical Journal Pub Date : 2023-04-04 DOI:10.2739/kurumemedj.MS681004
Kohei Saisho, Naoki Mori, Toshiaki Tanaka, Satoru Matono, Haruhiro Hino, Kazutaka Kadoya, Ryosuke Nishida, Masahiro Fujisaki, Masashi Nakagawa, Fumihiko Fujita, Masahiro Fujii, Takashi Yanagawa, Masahiro Mitsuoka, Yoshito Akagi
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引用次数: 0

摘要

背景:胃食管反流病(GERD)是食管切除术胃管重建术后常见的并发症。GerdQ问卷用于诊断初级保健患者的GERD。其在食管切除术后的疗效尚不清楚。在这项研究中,我们评估了GerdQ问卷在食管癌切除术后诊断GERD的有效性。材料与方法:2010年1月至2016年12月,124例食管癌患者行右侧经胸食管切除术并胃管重建术。分别于术后1个月、1年和2年行食管胃十二指肠镜检查和24小时食管ph测定。在相同的术后时间点进行GerdQ问卷调查。我们评估了GerdQ评分与内窥镜检查和ph检查结果之间的相关性。结果:术后1个月、1年、2年胃食管反流发生率分别为31.6%、46.9%、49.2%。当截断点为7时,GerdQ问卷在食管切除术后2年诊断GERD的敏感性为77%,特异性为56%。然而,术后各时间点的最佳截断点不同,评分在敏感性和特异性之间存在一定的不平衡。返流可能是一个有用的指标,因为在术后1年(P = 0.046)和2年(P = 0.048),有GERD的患者的返流频率明显高于无GERD的患者。结论:GerdQ问卷并不能作为食管癌切除术患者GERD的有效诊断工具。
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Effectiveness of the Gerdq Questionnaire for Diagnosing Gastroesophageal Reflux Disease After Esophagectomy for Esophageal Cancer.

Background: Gastroesophageal reflux disease (GERD) is a common complication after esophagectomy with gastric tube reconstruction. The GerdQ questionnaire was developed for diagnosing GERD in primary care patients. Its effectiveness in patients after esophagectomy remains unknown. In this study, we evaluated the usefulness of the GerdQ questionnaire for diagnosing GERD after esophagectomy for esophageal cancer.

Materials and methods: A total of 124 patients with esophageal cancer underwent right transthoracic esophagectomy with gastric tube reconstruction between January 2010 and December 2016. Esophagogastroduodenoscopy and 24-hour esophageal pH-metry were performed at 1 month, 1 year, and 2 years postoperatively. The GerdQ questionnaire was administered at the same postoperative time points. We assessed any correlation between the GerdQ scores and the endoscopy and pH-metry findings.

Results: The incidence rates of GERD at 1 month, 1 year and 2 years post-surgery were 31.6%, 46.9%, and 49.2%, respectively. The GerdQ questionnaire showed 77% sensitivity and 56% specificity for diagnosing GERD at 2 years after esophagectomy when the cutoff point was 7. However, the optimal cutoff points were different at each postoperative time, and the scores showed some imbalance between sensitivity and specificity. Regurgitation may be a useful indicator, as the frequency of regurgitation was significantly higher in patients with GERD than in patients without GERD at 1 year (P = 0.046) and 2 years postoperatively (P = 0.048).

Conclusion: The GerdQ questionnaire is not a useful diagnostic tool for GERD in patients who have undergone esophagectomy for esophageal cancer.

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Kurume Medical Journal
Kurume Medical Journal Medicine-Medicine (all)
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33
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