Whole stomach transposition without gastric drainage procedure: a good surgical option to restore digestive continuity after esophagectomy

Int Surg. 2007 Mar-Apr;92(2):73-7.

Abstract

After esophagectomy, the stomach is usually used to restore digestive continuity. To prevent postoperative delayed gastric emptying, most authors perform a gastric drainage procedure or transpose a tubulized stomach. The aim of our work is to evaluate the emptying of a transposed whole stomach without performing a pyloromyotomy or a pyloroplasty. From 1996 to January 2004, 45 patients underwent total esophagectomy for cancer or for caustic stenosis. Reconstruction of digestive continuity was realized through transposition of the whole stomach without performing a pyloric drainage procedure. At 12 months after the intervention, 35 patients (77.8%; 20 men and 15 women) were submitted to a gastric emptying scintigraphic study by means of ingestion of a mixed meal labeled with 37 MBq 99mTc-sulfur colloid. Mean half-emptying time was 71.4 minutes (range, 15-90 minutes; reference range, 83 +/- 34 minutes): all the patients were in the normal range except one. No patient complained of delayed gastric emptying symptoms. After esophagectomy, the transposition of the whole stomach without a pyloric drainage procedure seems to be an interesting option, and is not associated with delayed gastric emptying.

MeSH terms

  • Adult
  • Aged
  • Anastomosis, Surgical / methods
  • Drainage
  • Esophageal Neoplasms / surgery
  • Esophageal Stenosis / surgery
  • Esophagectomy / methods*
  • Female
  • Follow-Up Studies
  • Gastric Emptying / physiology
  • Gastrointestinal Contents / diagnostic imaging
  • Gastrointestinal Transit / physiology
  • Humans
  • Male
  • Middle Aged
  • Pylorus
  • Radionuclide Imaging
  • Radiopharmaceuticals
  • Stomach / surgery*
  • Technetium Tc 99m Sulfur Colloid
  • Time Factors

Substances

  • Radiopharmaceuticals
  • Technetium Tc 99m Sulfur Colloid