Gastric emptying after esophagectomy: comparing single therapy versus dual therapy method for pyloric drainage

• DOI: 10.21037/shc.2020.02.07
• Publication Date: 2020-10-10T08:50:59Z
• Authors: Christopher Decker; Caitlin Burke; Olatoye Olutola; Ashar Ata; John Nabagiez; Thomas Fabian
• Keywords: Esophagectomy

Background: Traditional protocols describe emptying procedures such as pyloroplasty and/or pyloromyotomy after an esophagectomy to improve gastric emptying. Pyloric Botox injections well pyloric dilation are safe alternatives that help unwanted side effects as. Few studies compare and specifically. Our study proposes alone with dilation. Methods: Data was gathered from one institution 2010 2016. A total of sixty-four patients esophageal cancer or high-grade dysplasia requiring were included. Patients did not receive excluded study. Endoscopic placement 20 mm CRETM balloon dilator inflated six atmospheres for a duration 5 minutes. Two hundred units mixed in cc normal saline injected into the pylorus via extraluminal approach. Chi square Fisher’s exact tests analyzed categorical variables. Results: Sixty-three met inclusion criteria underwent retrospective chart review. The dual therapy group included 46 (73%) patients. single 17 (27%) which 14 (22%) received 3 (5%) alone. average age this 63; 75% whom males. majority (75%) pathology adenocarcinoma. Delayed noted 9 (20%) 7 (41%) who only (P=0.08). Anastomotic leak identified 4 (6%) In group, 1 experienced anastomotic three (4%) (P=0.8). median length stay 16 days (range, 2–35 days) compared 10 6–20 (P=0.034). had greater than 21 23–35 patient therapy. Conclusions: Adding both combined procedure may outcomes minimally invasive esophagectomy. some centers intervention at time be justified reduce risks associated traditional procedures. ease these performed more pyloroplasty, justifies their use.