In:
The American Surgeon, SAGE Publications, Vol. 76, No. 10 ( 2010-10), p. 1135-1138
Abstract:
Pyloroplasty is performed during esophagectomy to avoid delayed gastric emptying. However, studies have shown that gastric function is minimally impaired even without a pyloroplasty when a gastric tube rather than the whole stomach is used for reconstruction. The aim of this study was to evaluate outcomes of minimally invasive esophagectomy without performance of a pyloroplasty. We performed a retrospective review of 145 patients who underwent a minimally invasive esophagectomy. The 30-day mortality was 2.1 per cent with an in-hospital mortality of 3.4 per cent. Of the 140 patients with more than 90 days follow-up, 31 patients had a pyloroplasty and 109 patients did not. One (3.2%) of 31 patients with pyloroplasty versus six (5.5%) of 109 patients without pyloroplasty developed delayed gastric emptying. There was no significant difference in the leak rate between the two groups (9.7% vs 9.6%, respectively). Total operative time was significantly shorter in the group without pyloroplasty (360 vs 222 minutes with a pyloroplasty, P 〈 0.01). Patients with delayed gastric emptying responded well to endoscopic pyloric dilation or Botox injection. The routine performance of a pyloroplasty during minimally invasive esophagectomy can be safely omitted with a reduction in operative time and minimal adverse effects on postoperative gastric function.
Type of Medium:
Online Resource
ISSN:
0003-1348
,
1555-9823
DOI:
10.1177/000313481007601026
Language:
English
Publisher:
SAGE Publications
Publication Date:
2010
