Document Detail


Anastomotic strictures and delayed gastric emptying after esophagectomy: incidence, risk factors and management.
MedLine Citation:
PMID:  18847448     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The aim of this study was to report the incidence, risk factors, and management of gastric conduit dysfunction after esophagectomy in 177 patients over a 3-year period in a single center. Patients with anastomotic strictures or delayed gastric emptying (DGE) were identified from a prospective database. Anastomotic strictures occurred in 48 patients (27%). Eighty-three percent of early anastomotic strictures (<1 year) were benign, and all late strictures (>1 year) were malignant. Dilatation was effective in 98% of benign and 64% of malignant strictures. DGE occurred in 21 patients (12%), and was associated with both anastomotic leak (P = 0.001) and anastomotic stricture (P = 0.001). 4/8 patients with late DGE (>3 months postesophagectomy) were tumor-related. Pyloric dilatation was effective in 92% of early and 63% of late DGE. Pyloric stents were inserted in 3 patients with tumor-related DGE. After esophagectomy, early anastomotic strictures (within 1 year) and early delayed gastric emptying (within 3 months) are usually benign and respond to dilatation. However, patients presenting later with tumor-related obstruction are unlikely to respond to anastomotic or pyloric dilatation and should be stented.
Authors:
R P Sutcliffe; M J Forshaw; R Tandon; A Rohatgi; D C Strauss; A J Botha; R C Mason
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Publication Detail:
Type:  Journal Article     Date:  2008-10-01
Journal Detail:
Title:  Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus / I.S.D.E     Volume:  21     ISSN:  1442-2050     ISO Abbreviation:  Dis. Esophagus     Publication Date:  2008  
Date Detail:
Created Date:  2008-12-01     Completed Date:  2009-03-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8809160     Medline TA:  Dis Esophagus     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  712-7     Citation Subset:  IM    
Affiliation:
Department of Surgery, St Thomas' Hospital, London, UK. rp_sutcliffe@yahoo.co.uk
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MeSH Terms
Descriptor/Qualifier:
Aged
Anastomosis, Surgical / adverse effects
Cohort Studies
Constriction, Pathologic / epidemiology,  pathology,  therapy
Esophageal Neoplasms / complications,  pathology,  surgery*
Esophagectomy / adverse effects*
Female
Gastric Emptying
Gastroparesis / diagnosis,  epidemiology*,  therapy*
Humans
Incidence
Intubation, Gastrointestinal / adverse effects
Male
Middle Aged
Retrospective Studies
Risk Factors
Stomach / surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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