TY - JOUR
T1 - Treating Early Delayed Gastric Tube Emptying after Esophagectomy with Pneumatic Pyloric Dilation
AU - Mertens, Alexander
AU - Gooszen, Jan
AU - Fockens, Paul
AU - Voermans, Rogier
AU - Gisbertz, Suzanne
AU - Bredenoord, Arjan
AU - van Berge Henegouwen, Mark Ivo
N1 - Funding Information: V.B.H. declares a research grant from Olympus and Stryker, in addition to consulting fees from Johnson and Johnson and Medtronic. P.F. declares consulting fees from Olympus, Cook, and Ethicon. The other authors have no conflicts of interest to declare. Publisher Copyright: © 2021 The Author(s) Published by S. Karger AG, Basel.
PY - 2021/11/2
Y1 - 2021/11/2
N2 - Introduction: Endoscopic pneumatic pyloric balloon dilation is a treatment option for early postoperative delayed gastric tube emptying following esophageal resection. This study aimed to determine the safety and effectiveness of endoscopic balloon dilation. Methods: Between 2015 and 2018, patients with delayed gastric emptying 8-10 days after esophageal resection with gastric tube reconstruction due to esophageal carcinoma were considered for inclusion. Inclusion criteria were ≥1 of the following: nasogastric tube production ≥500 mL/24 h, ≥300 mL gastric retention, ≥50% gastric tube dilatation on X-ray, or nasogastric tube replacement. Patients were excluded on evidence of anastomotic leakage or reintervention. Success was defined as the ability to expand intake without needing to replace the nasogastric tube. Dilation was performed using a 30-mm Rigiflex balloon. Results: Fifteen patients underwent pyloric dilation, 12 according to the study protocol. Treatment was performed at a median of 12 days (IQR 9-15) postoperatively. Success was achieved in 58%. At 3 months, 8 patients progressed to exclusively oral intake. The remaining 4 patients had supplementary nightly enteral tube feeding. There were no adverse events. Conclusion: Endoscopic balloon dilation of the pylorus is a safe, feasible therapy for early postoperative delayed gastric emptying. With a success rate of 58%, a clinical trial is a necessary next step.
AB - Introduction: Endoscopic pneumatic pyloric balloon dilation is a treatment option for early postoperative delayed gastric tube emptying following esophageal resection. This study aimed to determine the safety and effectiveness of endoscopic balloon dilation. Methods: Between 2015 and 2018, patients with delayed gastric emptying 8-10 days after esophageal resection with gastric tube reconstruction due to esophageal carcinoma were considered for inclusion. Inclusion criteria were ≥1 of the following: nasogastric tube production ≥500 mL/24 h, ≥300 mL gastric retention, ≥50% gastric tube dilatation on X-ray, or nasogastric tube replacement. Patients were excluded on evidence of anastomotic leakage or reintervention. Success was defined as the ability to expand intake without needing to replace the nasogastric tube. Dilation was performed using a 30-mm Rigiflex balloon. Results: Fifteen patients underwent pyloric dilation, 12 according to the study protocol. Treatment was performed at a median of 12 days (IQR 9-15) postoperatively. Success was achieved in 58%. At 3 months, 8 patients progressed to exclusively oral intake. The remaining 4 patients had supplementary nightly enteral tube feeding. There were no adverse events. Conclusion: Endoscopic balloon dilation of the pylorus is a safe, feasible therapy for early postoperative delayed gastric emptying. With a success rate of 58%, a clinical trial is a necessary next step.
KW - Delayed conduit emptying
KW - Esophageal cancer surgery
KW - Gastric tube reconstruction
KW - Gastroparesis
KW - Pyloric dilation
UR - http://www.scopus.com/inward/record.url?scp=85119019301&partnerID=8YFLogxK
U2 - https://doi.org/10.1159/000519785
DO - https://doi.org/10.1159/000519785
M3 - Article
C2 - 34727541
SN - 0253-4886
VL - 38
SP - 336
EP - 341
JO - Digestive Surgery
JF - Digestive Surgery
IS - 5-6
M1 - 519785
ER -