Role of pyloroplasty in the retrosternal stomach: Results of a prospective, randomized, controlled trial

Mannell, A; McKNIGHT, A.; Eßer, J

doi:10.1002/bjs.1800770120

Cited by 88 publications

(46 citation statements)

References 8 publications

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“…Even though many authors still include the drainage of the pylorus in the operative procedure (15). In the current study, with the exception of the first open 14 operated patients, who underwent a routine pyloroplasty procedure, the avoidance of this pyloroplasty in the following patients did not lead to any emptying problems of the gastric tube during the post-operative period (26). Therefore, we do not recommend a routine pyloroplasty as part of the gastric tube formation.…”

Section: Discussionmentioning

confidence: 51%

Laparoscopic versus open transhiatal esophagectomy for distal and junction cancer

Maas

Biere

Scheepers

et al. 2012

Rev. esp. enferm. dig.

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Background: the only curative treatment for esophageal cancer is surgical resection. This treatment is associated with a high morbidity rate and long in-hospital recovery period. Both transthoracic and transhiatal esophagectomies are performed worldwide. The transhiatal approach may reduce the respiratory infection rate in compromised patients with distal esophageal and gastro-esophageal (GE) cancers. Minimally invasive esophagectomy could further improve post-operative outcome. Two cohorts of laparoscopic and open transhiatal esophagectomy for cancer were compared for short-and long-term outcome.Methods: from January 2001 through December 2004, 50 patients who underwent laparoscopic transhiatal esophagectomy were compared to a historical group of 50 patients who had undergone open transhiatal esophagectomy between January 1998 and December 2000. Post-operative management was identical in both groups.Results: no significant differences were seen between the two groups with regard to baseline characteristics and oncological parameters including resection margin (R0 82 vs. 74%, p = 0.334) and 5-year survival. Operation time did not differ significantly between the groups. (300 vs. 280 min, p = 0.110). Median hospital stay and intensive care unit stay were significantly shorter in the laparoscopic group (13 vs. 16 days, p = 0.001 and 1 vs. 3 days, p = 0.000 respectively).Conclusion: minimally invasive transhiatal esophagectomy is feasible and has the same oncological outcome as open transhiatal esophagectomy. Faster recovery without a significant longer operation time could be the major benefit of the laparoscopic transhiatal approach. To our knowledge, this is the largest comparative study in literature comparing laparoscopic transhiatal with open transhiatal esophagectomy for cancers of distal and GE junction. Randomized trials are needed to further clarify the role of laparoscopic transhiatal approach for esophageal cancer.

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Section: Discussionmentioning

confidence: 51%

Laparoscopic versus open transhiatal esophagectomy for distal and junction cancer

Maas

Biere

Scheepers

et al. 2012

Rev. esp. enferm. dig.

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“…In some studies, in which the whole stomach or a wide gastric tube (stomach minus cardia) was interposed, delayed gastric emptying was found [28, 29, 30], although this could not be confirmed by other studies [9, 21, 23, 24, 31, 32]. Our data suggest a wide inter-patient variation in gastric emptying rate of solid food as well as in half emptying time of liquid food in comparison with healthy volunteers (own historical control group with same dual isotope scintigraphic technique, without enteral feeding: n = 16; median GER 32, range 25–42%/h; median T½ 24.5, range 7–62 min; unpublished data).…”

Section: Discussionmentioning

confidence: 99%

Disturbed Enterogastric Inhibitory Reflex after Esophageal Resection and Narrow Gastric Tube Reconstruction

Logeman

Borm²,

Lanschot³

et al. 1999

Dig Surg

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Background/Aims: The gastric emptying pattern after esophageal resection and narrow gastric tube reconstruction is determined by multiple factors. One of the possible factors is a disruption in the neurohumoral enterogastric inhibitory reflex. The aim of the present study was to determine the possible alterations of this reflex after esophageal resection and narrow gastric tube reconstruction. Methods: Nine patients each underwent two gastric tube emptying studies, one without and one with high caloric duodenal tube feeding. The dual isotope scintigraphic data were corrected for subject movement, radionuclide decay, downscatter and gamma-ray attenuation. Results: The median gastric tube emptying rate of solid food was 57%/h (range 27–195). The median T½ of liquid food was 67 (range 4–>80) min. Both for solid and for liquid food, the gastric tube emptying patterns without and with duodenal tube feeding were not significantly different. Conclusion: The neurohumoral enterogastric inhibitory reflex is disrupted after esophageal resection and narrow gastric tube reconstruction, which may contribute to disturbed gastric emptying.

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“…with time, 14 parallel to antral motor recovery. 6 Intraluminal acidity in the current study was not affected by erythromycin, a drug that enhances both antral motility 7 and emptying 15 after vagotomy, and it was even lower in the absence than in the presence of a gastric drainage procedure.…”

Section: Group 3 (N ‫؍‬ 42)mentioning

confidence: 99%

Denervated Stomach as an Esophageal Substitute Recovers Intraluminal Acidity With Time

Gutschow¹,

Collard²,

Romagnoli³

et al. 2001

Annals of Surgery

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ObjectiveTo determine whether the denervated stomach as an esophageal substitute recovers normal intraluminal acidity with time. Summary Background DataBilateral truncal vagotomy to the stomach as an esophageal substitute reduces both gastric acid production and antral motility, but a spontaneous motor recovery process takes place over years. MethodsIntraluminal gastric pH and bile were monitored during a 24-hour period 1 to 195 months after transthoracic elevation of the stomach as esophageal replacement in 91 and 76 patients, respectively. Nine patients underwent a second gastric pH monitoring after a 3-year period. The percentages of time that the gastric pH was less than 2 and bile absorbance exceeded 0.25 were calculated in reference to values from 25 healthy volunteers. Eighty-nine upper gastrointestinal endoscopies were performed in 83 patients. Patients were divided into three groups depending on length of follow-up: group 1, less than 1 year; group 2, 1 to 3 years; group 3, more than 3 years.

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Role of pyloroplasty in the retrosternal stomach: Results of a prospective, randomized, controlled trial

Cited by 88 publications

References 8 publications

Laparoscopic versus open transhiatal esophagectomy for distal and junction cancer

Laparoscopic versus open transhiatal esophagectomy for distal and junction cancer

Disturbed Enterogastric Inhibitory Reflex after Esophageal Resection and Narrow Gastric Tube Reconstruction

Denervated Stomach as an Esophageal Substitute Recovers Intraluminal Acidity With Time

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