Delayed Gastric Emptying Post-Esophagectomy: A Single-Institution Experience

Area of Science:

• Gastroenterology
• Thoracic Surgery
• Pulmonology

Background:

• Delayed gastric emptying (DGE) is a frequent complication following esophagectomy for esophageal cancer.
• Current management strategies for DGE are inconsistent, and the impact of comorbidities remains unclear.

Purpose of the Study:

• To identify factors influencing the development of postoperative DGE in patients undergoing esophagectomy.
• To investigate the relationship between comorbidities, surgical procedures, and DGE incidence.

Main Methods:

• Retrospective analysis of 149 patients who underwent esophagectomy with gastric pull-up between 2007 and 2019.
• Stratification of patients based on demographics, comorbidities (including diabetes and COPD), and surgical details.
• Comparison of DGE rates between different patient subgroups and surgical approaches.

Main Results:

• The overall incidence of DGE was 76.5%.
• Surgery type significantly impacted DGE rates (P = 0.005).
• All patients (100%) with chronic obstructive pulmonary disease (COPD) experienced DGE (P = 0.01), unlike diabetic patients (P = 0.25) or those undergoing pyloric procedures (P = 0.36).

Conclusions:

• The study identified a higher DGE incidence than previously reported, highlighting the need for a standardized definition.
• No significant association was found between diabetes and postoperative DGE.
• A strong link between COPD and DGE necessitates further investigation to understand the underlying mechanisms and optimize patient care.