American journal of surgery · 1995
Gastrointestinal function following esophagectomy for malignancy.
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Finley F J, Lamy A, Clifton J, Evans K G, Fradet G, Nelems B
Аннотация
BACKGROUND: The frequency and causes of gastrointestinal complications following esophagectomy for malignancy are unknown.
PATIENTS AND METHODS: We reviewed 295 esophagectomies performed for malignancy between January 1980 and September 1994 in order to determine the frequency and causes of early and late gastrointestinal complications.
RESULTS: Compared to transhiatal and left thoracoabdominal esophagectomies, esophagectomies carried out through a right posterolateral thoracotomy with cervical esophagogastric anastomosis had a higher incidence of delayed gastric emptying (11%), pneumonia (26%), and hospital death (9%). The same operation had a higher incidence of gastroesophageal reflux (20%) and dysphagia requiring esophageal dilatation (53%). We found no independent effect of gastric drainage procedures, feeding jejunostomy, preoperative radiotherapy, pathology, or age on these outcomes. Women had no operative mortality, but a higher incidence of gastroesophageal reflux and diarrhea following esophagectomy.
CONCLUSIONS: Surgical techniques aimed at improving gastric emptying following esophagectomy for cancer should improve operative morbidity and mortality.
PATIENTS AND METHODS: We reviewed 295 esophagectomies performed for malignancy between January 1980 and September 1994 in order to determine the frequency and causes of early and late gastrointestinal complications.
RESULTS: Compared to transhiatal and left thoracoabdominal esophagectomies, esophagectomies carried out through a right posterolateral thoracotomy with cervical esophagogastric anastomosis had a higher incidence of delayed gastric emptying (11%), pneumonia (26%), and hospital death (9%). The same operation had a higher incidence of gastroesophageal reflux (20%) and dysphagia requiring esophageal dilatation (53%). We found no independent effect of gastric drainage procedures, feeding jejunostomy, preoperative radiotherapy, pathology, or age on these outcomes. Women had no operative mortality, but a higher incidence of gastroesophageal reflux and diarrhea following esophagectomy.
CONCLUSIONS: Surgical techniques aimed at improving gastric emptying following esophagectomy for cancer should improve operative morbidity and mortality.
Предметные рубрики MeSH
AdenocarcinomaAdolescentAdultAgedAged, 80 and overAnastomosis, SurgicalCarcinoma, Squamous CellCardiaDeglutition DisordersDrainageEsophageal NeoplasmsEsophagectomyEsophagusFemaleFollow-Up StudiesGastric EmptyingGastroesophageal RefluxHospital MortalityHumansIncidenceJejunostomyMaleMiddle AgedPneumoniaReoperationStomach NeoplasmsSurvival Rate