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

• Published in: International surgery Vol. 92; no. 2; p. 73
• Main Authors: Maffettone, Vincenzo, Rossetti, Gianluca, Rambaldi, Pierfrancesco, Russo, Federica, Cuccurullo, Vincenzo, Brusciano, Luigi, del Genio, Gianmattia, Russo, Gianluca, Pizza, Francesco, Mansi, Luigi, del Genio, Alberto
• Format: Journal Article
• Language: English
• Published: Italy 01-03-2007
• Subjects: 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
• ISSN: 0020-8868

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.