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Mertens A, Gooszen J, Fockens P, et al. Treating Early Delayed Gastric Tube Emptying after Esophagectomy with Pneumatic Pyloric Dilation. Dig Surg. 2021;38(5):337-342doi: 10.1159/000519785.
Mertens, A., Gooszen, J., Fockens, P., Voermans, R., Gisbertz, S., Bredenoord, A., & van Berge Henegouwen, M. I. (2021). Treating Early Delayed Gastric Tube Emptying after Esophagectomy with Pneumatic Pyloric Dilation. Digestive surgery, 38(5), 337-342. https://doi.org/10.1159/000519785
Mertens, Alexander, et al. "Treating Early Delayed Gastric Tube Emptying after Esophagectomy with Pneumatic Pyloric Dilation." Digestive surgery vol. 38,5 (2021): 337-342. doi: https://doi.org/10.1159/000519785
Mertens A, Gooszen J, Fockens P, Voermans R, Gisbertz S, Bredenoord A, van Berge Henegouwen MI. Treating Early Delayed Gastric Tube Emptying after Esophagectomy with Pneumatic Pyloric Dilation. Dig Surg. 2021;38(5):337-342. doi: 10.1159/000519785. Epub 2021 Nov 02. PMID: 34727541.
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Dig Surg. 2021;38(5):337-342. doi: 10.1159/000519785. Epub 2021 Nov 02.

Treating Early Delayed Gastric Tube Emptying after Esophagectomy with Pneumatic Pyloric Dilation.

Digestive surgery

Alexander Mertens, Jan Gooszen, Paul Fockens, Rogier Voermans, Suzanne Gisbertz, Arjan Bredenoord, Mark Ivo van Berge Henegouwen

Affiliations

  1. Department of Surgery, Amsterdam University Medical Centers, location AMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands.
  2. Robotics and Mechatronics, University of Twente, Enschede, The Netherlands.
  3. Department of Gastroenterology & Hepatology, Amsterdam University Medical Centers, location AMC, University of Amsterdam, Amsterdam Gastroenterology & Metabolism, Amsterdam, The Netherlands.

PMID: 34727541 DOI: 10.1159/000519785

Abstract

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.

© 2021 The Author(s) Published by S. Karger AG, Basel.

Keywords: Delayed conduit emptying; Esophageal cancer surgery; Gastric tube reconstruction; Gastroparesis; Pyloric dilation

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