Delayed Gastric Emptying Post-Esophagectomy: A Single-Institution Experience
| Autor: | James E. Stephenson, Stella Self, William Lorenz, Sharon Ben-Or, Christine Schammel, Allison Frederick, William D. Bolton |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Gastroparesis medicine.medical_treatment Gastroenterology Functional disorder 03 medical and health sciences 0302 clinical medicine Postoperative Complications Internal medicine Diabetes mellitus Carcinoma medicine Humans Pylorus Retrospective Studies Gastric emptying business.industry Incidence (epidemiology) fungi Retrospective cohort study General Medicine medicine.disease Esophagectomy Gastric Emptying 030220 oncology & carcinogenesis Cohort 030211 gastroenterology & hepatology Surgery Cardiology and Cardiovascular Medicine business |
| Zdroj: | Innovations (Philadelphia, Pa.). 15(6) |
| ISSN: | 1559-0879 |
| Popis: | Objective Delayed gastric emptying (DGE) is a common functional disorder after esophagectomy in patients with esophageal carcinoma. Management of DGE varies widely and it is unclear how comorbidities influence the postoperative course. This study sought to determine factors that influence postoperative DGE. Methods This retrospective study evaluates patients who underwent esophagectomy with gastric pull-up between 2007 and 2019. The cohort was stratified in various ways to determine if postoperative care and outcomes differed, including patient demographics, comorbidities, intraoperative and postoperative procedures. Results During the study period, 149 patients underwent esophagectomy and 37 had diabetes. Overall incidence of DGE, as defined in this study, was 76.5%. Surgery type was significantly different between DGE and normal emptying cohorts ( P = 0.005). Comparing diabetic and nondiabetic patients, there was no significant difference noted in DGE ( P = 0.25). Additionally, there was no difference in presence of DGE for patients who underwent any intraoperative pyloric procedure compared to those who did not ( P = 0.36). Of significance, all 16 patients with chronic obstructive pulmonary disease had a delay in gastric emptying ( P = 0.01). Conclusions A higher proportion of patients with DGE post-esophagectomy were identified compared to the literature. There is little consensus on a true definition of DGE, but we believe this definition identifies patients suffering in the immediate postoperative period and in follow-up. There is no evidence to support a different postoperative course for patients with diabetes, but the link between chronic obstructive pulmonary disease and DGE warrants further investigation. |
| Databáze: | OpenAIRE |
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