Gastric Outlet Obstruction After Esophagectomy: Retrospective Analysis of the Effectiveness and Safety of Postoperative Endoscopic Pyloric Dilatation

Autor: Till Herbold, Hakan Alakus, Daniel A. Hescheler, Robert Kleinert, H. Schäfer, Marc Bludau, Arnulf H. Hölscher, Seung-Hun Chon, Elfriede Bollschweiler, Jessica M. Leers, Martin K. H. Maus
Rok vydání: 2016
Předmět:
Zdroj: World Journal of Surgery. 40:2405-2411
ISSN: 1432-2323
0364-2313
DOI: 10.1007/s00268-016-3575-1
Popis: Delayed gastric emptying after esophagectomy with gastric replacement can pose a significant postoperative problem, often leading to aspiration and pneumonia. The present study analyzes retrospectively the effectiveness of endoscopic pyloric dilatation for post-surgical gastric outlet obstruction. Between March 2006 and March 2010, 403 patients underwent a transthoracic en-bloc esophagectomy and reconstruction with a gastric tube and intrathoracic esophagogastrostomy. In patients with postoperative symptoms of an outlet dysfunction and the confirmation by endoscopy, pyloric dilatations were performed without preference with either 20- or 30-mm balloons. A total of 89 balloon dilatations of the pylorus after esophagectomy were performed in 60 (15.6 %) patients. In 21 (35 %) patients, a second dilatation of the pylorus was performed. 55 (61.8 %) dilatations were performed with a 30-mm balloon and 34 (38.2 %) with a 20-mm balloon. The total redilatation rate for the 30-mm balloon was 20 % (n = 11) and 52.9 % (n = 18) for the 20-mm balloon (p
Databáze: OpenAIRE
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