Is Chemical Pyloroplasty Necessary for Minimally Invasive Esophagectomy?

Stewart, Camille L.; Wilson, Laird; Hamm, Aidan; Bartsch, Christan; Boniface, Megan; Gleisner, Ana; Mitchell, John D.; Weyant, Michael J.; Meguid, Robert A.; Gajdos, Csaba; Edil, Barish H.; McCarter, Martin D.

doi:10.1245/s10434-016-5742-x

Cited by 11 publications

(10 citation statements)

References 18 publications

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“…However, Eldaif et al [39] reported that although the use of IPBT significantly decreased the operative time compared to pyloromyotomy and pyloroplasty, the patients who received IPBT suffered from more reflux symptoms, had more frequent use of promotility drugs, needed more frequent endoscopic pyloric interventions, and had no benefits compared to those who underwent pyloromyotomy and pyloroplasty in terms of reducing dumping symptoms. In a well-matched cohort study, Stewart et al [40] demonstrated a similar incidence of DGE between patients who received no pyloric intervention and those who received IPBT in the setting of minimally invasive esophagectomy.…”

Section: Managementmentioning

confidence: 92%

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Delayed Gastric Emptying after Esophagectomy: Management and Prevention

Yang

Choi

Kim

et al. 2020

Korean J Thorac Cardiovasc Surg

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The quality of life associated with eating is becoming an increasingly significant problem for patients who undergo esophagectomy as a result of the improved survival rate after esophageal cancer surgery. Delayed gastric emptying (DGE) is a common complication after esophagectomy. Although several strategies have been proposed for the management and prevention of DGE, no clear consensus exists. The purpose of this review is to present a brief overview of DGE and to help clinicians choose the most appropriate treatment through an analysis of DGE by cause. Furthermore, we would like to suggest some tips to prevent DGE based on our experience.

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Section: Managementmentioning

confidence: 92%

“…Each method has its advantages and disadvantages, so we cannot say with certainty which one is the best. However, advocates for the no-intervention strategy have been gradually reporting convincing results [40,55,56].…”

Section: Pyloric Drainage Proceduresmentioning

confidence: 99%

Delayed Gastric Emptying after Esophagectomy: Management and Prevention

Yang

Choi

Kim

et al. 2020

Korean J Thorac Cardiovasc Surg

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“…Botulinum injection is associated with higher rates of reflux symptoms (35). When compared directly to patients with no intraoperative pyloric intervention, rates of delayed gastric emptying were equivalent in both groups and there was no significant difference in need for additional pyloric procedure (36).…”

Section: Pylorusmentioning

confidence: 98%

Factors resulting in postoperative dysphagia following esophagectomy: a narrative review

Benz¹,

Martella²,

Hamwi³

et al. 2021

J Thorac Dis

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Esophagectomy is a technically involved surgery and can have significant postoperative morbidity. Although the mortality rate following esophagectomy has decreased in recent years, this surgical procedure has a relatively high complication rate compared to other surgeries to resect cancer. One of the most common complaints after esophagectomy is dysphagia. Dysphagia after esophagectomy can significantly affect quality of life. Dysphagia is a complication following esophagectomy that can lead to respiratory deterioration and death. The most common sites of postoperative dysphagia are the gastroesophageal anastomosis, gastric conduit, pylorus and the hiatus. Without appropriate treatment of dysphagia, malnutrition and dehydration can develop. These factors can lead to significant impacts to the overall health of a patient and increase mortality. A detailed literature review provided data to support diagnostic modalities and management strategies to treat postoperative dysphagia at these common areas. A systematic, evidencebased approach to diagnosis and treatment of postoperative dysphagia allows for prompt intervention and a decrease in morbidity and mortality. Treatment options for dysphagia vary, depending on the etiology. Based on the location and mechanism of dysphagia, options include stenting, dilation and surgical revision. Early treatment of dysphagia after esophagectomy can lessen the morbidity from this complication and improve quality of life.

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“…Furthermore, a study doubted the necessity of IBTJ in minimally invasive esophagectomy patients as both IBTJ and no-intervention controlled group had low incidence of DGE (IBTJ: 8.6%, 3/35 vs. Controlled: 5.6%, 2/36) (19). Fortunately, a phase II RCT (NCT02965976) is recruiting patients to answer this unsolved problem and hopefully we will know whether we should perform IBTJ in esophagectomy patients before long.…”

Section: Ibtjmentioning

confidence: 99%

Management of delayed gastric conduit emptying after esophagectomy

Zhang¹

2019

J. Thorac. Dis

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Delayed gastric conduit emptying (DGE) is a common complication after esophagectomy. Currently, pyloric interventions are the major prevention and treatment for DGE. In this review, we attempt to evaluate the clinical effect and safety of different pyloric interventions in esophagectomy patients. Moreover, other important management of DGE, including size of esophageal substitute, erythromycin and nasogastric tube (NGT) will also be discussed.

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Is Chemical Pyloroplasty Necessary for Minimally Invasive Esophagectomy?

Cited by 11 publications

References 18 publications

Delayed Gastric Emptying after Esophagectomy: Management and Prevention

Delayed Gastric Emptying after Esophagectomy: Management and Prevention

Factors resulting in postoperative dysphagia following esophagectomy: a narrative review

Management of delayed gastric conduit emptying after esophagectomy

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