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Related Experiment Videos

Gastrointestinal function following esophagectomy for malignancy

F J Finley1, A Lamy, J Clifton

  • 1Department of Surgery, Vancouver Hospital, British Columbia, Canada.

American Journal of Surgery
|May 1, 1995
PubMed
Summary

Esophagectomy for cancer can lead to gastrointestinal complications. Right posterolateral thoracotomy with cervical anastomosis increased risks of delayed gastric emptying, pneumonia, and death compared to other methods.

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Area of Science:

  • Surgical Oncology
  • Gastroenterology
  • Thoracic Surgery

Background:

  • Gastrointestinal complications after esophagectomy for malignancy are not well understood.
  • Determining the frequency and causes of these complications is crucial for patient outcomes.

Purpose of the Study:

  • To investigate the frequency and causes of early and late gastrointestinal complications following esophagectomy for malignancy.
  • To compare complication rates across different surgical approaches.

Main Methods:

  • A retrospective review of 295 esophagectomies performed for malignancy between January 1980 and September 1994.
  • Analysis of early and late gastrointestinal complications, including delayed gastric emptying, pneumonia, hospital death, gastroesophageal reflux, and dysphagia.

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Main Results:

  • Esophagectomies via right posterolateral thoracotomy with cervical anastomosis showed higher rates of delayed gastric emptying (11%), pneumonia (26%), and hospital death (9%) compared to transhiatal and left thoracoabdominal approaches.
  • This surgical approach also resulted in increased gastroesophageal reflux (20%) and dysphagia requiring esophageal dilatation (53%).
  • No significant impact was found from gastric drainage, feeding jejunostomy, preoperative radiotherapy, pathology, or age. Women experienced no operative mortality but higher rates of reflux and diarrhea.

Conclusions:

  • Surgical techniques focusing on improving gastric emptying post-esophagectomy for cancer are essential.
  • Optimizing surgical methods can potentially reduce operative morbidity and mortality associated with esophagectomy.