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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
This summary is machine-generated.

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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.

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.

Related Experiment Videos

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.