Functional disorders and quality of life after esophagectomy and gastric tube reconstruction for cancer

Abstract

Functional disorders such as delayed gastric emptying, dumping syndrome or duodeno-gastro-esophageal reflux occur in half of the patients who undergo esophagectomy and gastric tube reconstruction for cancer. The potential role for pyloroplasty in the prevention of functional disorders is still debated. Antireflux fundoplication during esophagectomy can apparently reduce the reflux but at the cost of increasing the complexity of the operation; it is not widely used. The treatment of functional disorders arising after esophagectomy and gastroplasty for cancer is based mainly on dietary measures. Proton pump inhibitors have well documented efficiency and should be given routinely to prevent reflux complications. Erythromycin may prevent delayed gastric emptying, but it should be used with caution in patients with cardiovascular disorders. In the event of anastomotic stricture, endoscopic dilatation is usually efficient. Problems related to gastrointestinal functional disorders after esophageal resection and gastric tube reconstruction do not significantly impair long-term quality of life, which is mainly influenced by tumor recurrence.

Nutrition in peri-operative esophageal cancer management

“…Functional disorders such as gastric emptying disorders (accelerated or delayed emptying), gastroesophageal reflux, anastomotic stricture, and dumping syndrome occur in half of the patients after esophagectomy and gastric tube reconstruction for cancer [100]. These problems play an important role in causing weight loss and a decline in nutritional status observed after esophagectomy.…”

“…These problems play an important role in causing weight loss and a decline in nutritional status observed after esophagectomy. Personalized dietary counseling is the main tool for controlling these disorders and should focus on achieving an individually appropriate dietary balance [89,100,101].…”

Unilateral Upper Lung Field Pulmonary Fibrosis Radiologically Consistent with Pleuroparenchymal Fibroelastosis after Thoracotomy: A New Disease Entity Related to Thoracotomy

“…We believe that the clinical courses of an apical cap in the nonoperated side, which was observed during the first visit in [2,12] , we believe that our 3 patients with a history of gastroesophageal resection potentially had a mechanism of microaspiration, which resulted in repeated low-grade inflammation. Generally, gastroesophageal reflux disease (GERD) and delayed gastric emptying easily develop in patients with a history of gastrectomy or esophagectomy [15][16][17] and can cause aspiration pneumonia [18] . In fact, 2 patients treated with esophagectomy (cases 4 and 5) had an apparent air-fluid level in the remaining esophagus and intrathoracic stomach ( Fig.…”

Application of Oesophagogastric Cervical Mechanical Anastomosis in Oesophagectomy for Cancer

“…Thus, we pulled up the stomach to encase the anastomosis by a stapler after the anastomosis procedure. This measure increases the pressure that the cervical muscles and soft tissue place on the anastomotic site, enhances the pressure difference between the oesophagus and the stomach at the anastomosis and helps relieve postoperative gastro-oesophageal reflux [19][20][21][22].…”