Replacing Pyloromyotomy by Thumb Dilatation in Esophagogastrectomy.
Replacing Pyloromyotomy by Thumb Dilatation in Esophagogastrectomy.
Keywords:
Pyloromyotomy, esophagogastrectomy, Thumb dilitation
Abstract
Background: Esophagogastrectomy is frequently being done at our centre. Subjecting the patient to formal pyloromyotomy is debatable.
Aim: This study aimed to compare the results of formal pylaroplasty with simple thumb dilatation after esophagogastrectomy.
Material and methods: Two hundred patients with abdominal esophagogastrectomy were included in the study. Thumb dilation of the pylorus was done in 120 patients (Study group) and formal pylaromyotomy (Control group) was done in 80 patients.
Results: The amount of Ryles tube aspirate and its duration was similar in both groups. There was no significant difference in the amount of aspirate in both groups. The average duration of Ryles tube aspirate was 3 days in the study group and 4 days in the control group. Recovery from postoperative ileus was earlier in the study group than control group.
Conclusion: Thumb dilatation of pylorus is simple, ideal, less invasive and as effective as routine pylaroplasty after esophagogastrectomy.
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References
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2. Fang W, Igaki H, Tachimori Y, Sato H, Daiko H, Kato H. Three-field lymph node dissection for esophageal cancer in elderly patients over 70 years of age. Ann Thorac Surg 2001;72:867-871.
3. Lerut T, Coosemans W, Leyn PD, Raemdonck DV, Deneffe G, Decker G. Treatment of esophageal carcinoma. Chest 1999;116:463S-465S.
4. Ando N, Ozawa S, Kitagawa Y, Shinozawa Y, Kitajima M. Improvement in the results of surgical treatment of advanced squamous esophageal carcinoma during 15 consecutive years. Ann Surg 2000;232:225-232.
5. Hinder RA, Esser J, Demeester TR. Management of gastric emptying disorders following Roux-en-Y procedure. Surgery 1988;104:756-772.
6. Collard JM, Otte JB, Reynaert M, Kastens PJ. Quality of life three years or more after esophagectomy for cancer. J Thorac Cardiovasc Surg 1992;104:391-394.
7. Lee HS, Kim MS, Lee JM, Kim SK, Kang KW, Zo JI. Intrathoracic gastric emptying of solid food after esophagectomy for esophageal cancer. Ann Thorac Surg 2005;80:443-448.
8. Wang Yong-gang, Zhang Ru-gang, Zhang Da-wei. Research on intra-thoracic gastric function after esophagectomy. Chinese Journal of Tumor 1997;19:385–8.
9. Zhao Chong-wei, Wang De-jiang, Pan Shu-hua et al. Total gastric replacement of esophagus through primary esophageal-bed in the treatment of high positioned esophageal carcinoma. Journal of Shandong Medical University 1991;29:149–51.
10. Branicki FJ, Law SY, Fok M, Poon RT, Chu KM, Wong J. Quality of life in patients with cancer of the esophagus and gastric cardia: a case for palliative resection. Arch Surg 1998;133:316-322.
11. Fok M, Cheng SW, Wong J. Pyloroplasty versus no drainage in gastric replacement of the esophagus. Am J Surg 1991;162:447-452.
12. Law S, Cheung MC, Fok M, Chu KM, Wong J. Pyloroplasty and pyloromyotomy in gastric replacement of the esophagus after esophagectomy: a randomized controlled trial. J Am Coll Surg 1997;184:630-636.
13. Hill AD, Walsh TN, Hamilton D, Freyne P, O’Hare N, Byrne PF, Hennessy PJ. Erythromycin improves emptying of the denervated stomach after oesophagectomy. Br J Surg 1993;80:879-881.
14. Bemelman WA, Brummelkamp WH, Bartelsman JF. Endoscopic balloon dilatation of the pylorus after esophagogastrostomy without a drainage procedure. Surg Gynecol Obstet 1990;170:424-426.
15. Urschel JD, Blewett CJ, Young JE, Miller JD, Bennett WF. Pyloric drainage (pyloroplasty) or no drainage is gastric reconstruction after esophagectomy: a meta-analysis of randomized controlled trials. Dig Surg 2002;19:160-164.
16. Lanuti M, de Delva PE, Wright CD, Gaissert HA, Wain JC, Donahue DM, Allan JS, Mathisen DJ. Post-esophagectomy gastric outlet obstruction: role of pyloromyotomy and management with endoscopic pyloric dilatation. Eur J Cardiothorac Surg 2007;31:149-153.
17. Fok M, Cheng SW, Wong J. Pyloroplasty versus no drainage in gastric replacement of the esophagus. Am J Surg 1991; 162:447–452.
18. Zieren HU, Muller JM, Jacobi CA, Pichlmaier H. Should a pyloroplasty be carried out in stomach transposition after subtotal esophagectomy with esophago-gastric anastomosis at the neck? A prospective randomized study. [German]. Chirurg 1995; 66:319–325.
19. Mannell A, McKnight A, Esser JD. Role of pyloroplasty in the retrosternal stomach: results of a prospective, randomized, controlled trial. Br J Surg 1990; 77:57–59.
20. Chattopadhyay TK, Gupta S, Padhy AK, Kapoor VK. Is pyloroplasty necessary following intrathoracic transposition of stomach? Results of a prospective clinical study. Aust NZ J Surg 1991; 61:366–369.
21. Kobayashi A, Ide H, Eguchi R, Nakamura T, Hayashi K, Hanyu F. The efficacy of pyloroplasty affecting to oral-intake quality of life using reconstruction with gastric tube post esophagectomy [Japanese]. Nippon Kyobu Geka Gakkai Zasshi – J Jpn Ass Thor Surg 1996; 44:770–778.
22. Cheung HC, Siu KF, Wong J. Is pyloroplasty necessary in esophageal replacement by stomach? A prospective, randomized controlled trial. Surgery 1987; 102:19–24.
Published
2024-06-12
How to Cite
1.
Malik AA, Wagay BA, Yousuf J, Wani MA, Hassan Y. Replacing Pyloromyotomy by Thumb Dilatation in Esophagogastrectomy. jms [Internet]. 2024Jun.12 [cited 2026Oct.3];27(2):19-2. Available from: https://old.jmsskims.org/index.php/jms/article/view/1377
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Original Articles
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