Proper preparation to reduce endoscopic reexamination due to food residue after distal gastrectomy for gastric cancer

Abstract

Patients who undergo follow-up endoscopy after surgery should fast more than 18 h and ingest a soft or liquid diet on the day before examination.

Endoscopic Submucosal Dissection of Gastric Epithelial Neoplasms after Partial Gastrectomy: A Single-Center Experience

“…Furthermore, such lesions are generally located in the upper third of the stomach, which increases the difficulty of manipulating the endoscope and maintaining a suitable distance and direction between the lesion and the endoscope [10]. Furthermore, food residue is frequently observed in the remnant stomach, which can also hinder endoscopic procedures [20, 21]. In the present study, food residues were not identified, except in 1 patient whose procedure was postponed to the following day.…”

Incidence of food residue interfering with postoperative endoscopic examination for gastric pull-up after esophagectomy

“…The second reason is that the present study only evaluated the first endoscopic images, even if the patient had undergone multiple endoscopies at our center. Repeated examinations probably reduce the food residue from the gastric pull-up because the patients try to prepare more carefully than in their previous failed examinations [10,11].…”

“…Unfortunately, we failed to determine the risk factors for the food residue. To decrease the incidence, fasting more than 18 h before the examination [11], drinking water on the evening before and on the day of the endoscopy [10,17], and ingesting only a liquid or soft diet on the day before the examination [11] have been recommended for gastrectomized patients to reduce the food residue in their gastric remnant. These preparation methods can also be applied for esophagectomized patients to minimize the presence of food residue from their gastric pull-ups.…”

“…The presence of food residue can obscure the tract surface, resulting in overlooked lesions or a requirement of reexamination [10,11]. In spite of appropriate preparation, food residue that interferes with the examination is occasionally observed in an operated stomach because of its gastro-pyloric hypomotility [12].…”

“…Conclusion The food residue interfering with postoperative endoscopic examination was observed in 17.2 % of all surveyed gastric pull-ups. residue and its risk factors in the gastric remnant after partial gastrectomy has been studied by endoscopic evaluation [10,11,13,14], there have been few studies of this kind on the gastric pull-up after esophagectomy. The aims of the present study were to elucidate the incidence and potential risk factors associated with food residue in gastric pull-up after esophagectomy.…”