Universität zu Köln

Maus, Martin K. H., Leers, Jessica, Herbold, Till, Bludau, Marc, Chon, Seung-Hun ORCID: 0000-0002-8923-6428, Kleinert, Robert, Hescheler, Daniel A., Bollschweiler, Elfriede, Hoelscher, Arnulf H., Schaefer, Hartmut and Alakus, Hakan (2016). Gastric Outlet Obstruction After Esophagectomy: Retrospective Analysis of the Effectiveness and Safety of Postoperative Endoscopic Pyloric Dilatation. World J.Surg., 40 (10). S. 2405 - 2412. NEW YORK: SPRINGER. ISSN 1432-2323

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Abstract

Delayed gastric emptying after esophagectomy with gastric replacement can pose a significant postoperative problem, often leading to aspiration and pneumonia. The present study analyzes retrospectively the effectiveness of endoscopic pyloric dilatation for post-surgical gastric outlet obstruction. Between March 2006 and March 2010, 403 patients underwent a transthoracic en-bloc esophagectomy and reconstruction with a gastric tube and intrathoracic esophagogastrostomy. In patients with postoperative symptoms of an outlet dysfunction and the confirmation by endoscopy, pyloric dilatations were performed without preference with either 20- or 30-mm balloons. A total of 89 balloon dilatations of the pylorus after esophagectomy were performed in 60 (15.6 %) patients. In 21 (35 %) patients, a second dilatation of the pylorus was performed. 55 (61.8 %) dilatations were performed with a 30-mm balloon and 34 (38.2 %) with a 20-mm balloon. The total redilatation rate for the 30-mm balloon was 20 % (n = 11) and 52.9 % (n = 18) for the 20-mm balloon (p < 0.001). All dilatations were performed without any complications. Pylorus spasm contributes to delayed gastric emptying leading to postoperative complications after esophagectomy. Endoscopic pyloric dilatation after esophagectomy is a safe procedure for treatment of gastric outlet obstruction. The use of a 30-mm balloon has the same safety profile but a 2.5 lower redilatation rate compared to the 20-mm balloon. Thus, the use of 20-mm balloons has been abandoned in our clinic.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Maus, Martin K. H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Leers, Jessica UNSPECIFIED UNSPECIFIED UNSPECIFIED Herbold, Till UNSPECIFIED UNSPECIFIED UNSPECIFIED Bludau, Marc UNSPECIFIED UNSPECIFIED UNSPECIFIED Chon, Seung-Hun UNSPECIFIED orcid.org/0000-0002-8923-6428 UNSPECIFIED Kleinert, Robert UNSPECIFIED UNSPECIFIED UNSPECIFIED Hescheler, Daniel A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bollschweiler, Elfriede UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoelscher, Arnulf H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schaefer, Hartmut UNSPECIFIED UNSPECIFIED UNSPECIFIED Alakus, Hakan UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-260959
DOI:	10.1007/s00268-016-3575-1
Journal or Publication Title:	World J.Surg.
Volume:	40
Number:	10
Page Range:	S. 2405 - 2412
Date:	2016
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1432-2323
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language BALLOON DILATATION; DENERVATED STOMACH; NO DRAINAGE; PYLOROPLASTY; REPLACEMENT; RECONSTRUCTION; SUBSTITUTE; CANCER; REFLUX; TRIAL Multiple languages Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/26095