Related Experiment Video
Updated: Apr 30, 2026
09:40
An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
Published on: April 17, 2020
16.7K
Intrapyloric botulinum injection increases postoperative esophagectomy complications
Shady M Eldaif1, Richard Lee1, Kumari N Adams1
1Department of Surgery, Section of General Thoracic Surgery, Emory University School of Medicine, Atlanta, Georgia.
The Annals of Thoracic Surgery
|May 6, 2014
Summary
Intrapyloric botulinum toxin injection reduces operative time but increases reflux symptoms and need for endoscopic intervention. Pyloromyotomy is recommended over botulinum injection for esophagectomy drainage.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Gastrointestinal Surgery
Background:
- Intrapyloric botulinum toxin injection is a potential alternative to standard pyloric drainage.
- Potential benefits include reduced operative time and fewer post-operative symptoms.
- Evidence comparing botulinum injection to standard procedures is limited.
Purpose of the Study:
- To compare the outcomes of intrapyloric botulinum toxin injection with pyloromyotomy and pyloroplasty in patients undergoing esophagectomy.
Main Methods:
- Retrospective review of a prospective database (2005-2010).
- Analysis of 322 patients divided into botulinum injection (n=78), pyloromyotomy (n=45), and pyloroplasty (n=199) groups.
- Comparison of operative time, delayed gastric emptying, need for dilation, promotility agent use, and symptom experience.
Main Results:
- Botulinum injection significantly reduced operative time (239 min vs. 312-373 min).
- No significant difference in delayed gastric emptying between groups.
- Increased postoperative reflux (32% vs. 12-13%) and need for pyloric dilation (22% vs. 2-4%) in the botulinum group.
Conclusions:
- Intrapyloric botulinum injection decreases operative time but leads to more reflux and need for endoscopic intervention.
- Botulinum injection does not reduce postoperative dumping.
- Pyloromyotomy is the preferred drainage procedure for esophagectomy.
Related Concept Videos
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
1.2K
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
1.2K
01:11Pyloric Obstruction
40
Pyloric obstruction, also referred to as gastric outlet obstruction, is a condition characterized by narrowing or blockage at the pylorus—the muscular valve regulating the flow of stomach contents into the duodenum. When this passage becomes impaired, the stomach cannot effectively empty its contents into the small intestine. This disruption leads to a range of gastrointestinal symptoms, including early satiety, bloating, epigastric pain, postprandial nausea, persistent vomiting, and...
40
01:26Esophageal Strictures-II: Clinical Features and Management
1.1K
Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
1.1K
01:25Peptic Ulcer Disease V: Surgical Management and Nursing Care
1.3K
Surgical management and nursing care are crucial in treating Peptic Ulcer Disease (PUD). Here is an organized and enhanced overview of the surgical interventions and the associated nursing care for PUD:
Surgical Interventions for Peptic Ulcer Disease
Surgical Interventions for Peptic Ulcer Disease
1.3K
01:15Enteral Nutrition II: Nasointestinal and Gastrostomy Feeding
2.0K
Enteral nutrition encompasses various methods of delivering nutrition directly to the gastrointestinal (GI) tract, bypassing traditional oral intake. It is particularly beneficial for patients who cannot eat by mouth but have a functioning digestive system. Key methods include nasointestinal feeding, gastrostomy, and jejunostomy, each suited to different clinical scenarios based on the patient's needs and condition.
Nasointestinal Feeding
Nasointestinal feeding involves placing a tube...
Nasointestinal Feeding
Nasointestinal feeding involves placing a tube...
2.0K
01:28Esophageal Perforation-II: Clinical Manifestations and Management
1.1K
Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Clinical Manifestations:
1.1K