Journal article
Circular stapled pyloroplasty: a fast and effective technique for pyloric disruption during esophagectomy with gastric pull-up
Diseases of the esophagus, v 24(6), pp 423-429
01 Aug 2011
PMID: 21309918
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
The necessity of pyloroplasty after esophagectomy and gastric pull-up is debated. Disadvantages of a standard pyloroplasty include the potential for leak, shortening of the length of the graft, and complexity when done during a minimally invasive procedure. The aim of this study is to report our experience with a novel internal pyloroplasty technique using a circular stapler (CS pyloroplasty), which is applicable for both laparoscopic and open esophagectomy. The records of all patients who underwent an esophagectomy with gastric pull-up and pyloroplasty between 2002 and 2007 were reviewed. The CS pyloroplasty was performed through a lesser curve gastrotomy with a 21-mm CS, while the standard pyloroplasty entailed a longitudinal full thickness incision through the pylorus with mucosal closure in the same direction and a Graham patch. A CS pyloroplasty was performed in 144 and a standard pyloroplasty in 133 patients. The median patient age was 66 years, and the median follow-up was 17 months, and was similar for both types of pyloroplasty. Routine postoperative videoesophagram was significantly more likely to show a delay in contrast transit through the pylorus after standard pyloroplasty (16% standard vs. 8% CS pyloroplasty, P = 0.03). Significantly more patients had postoperative endoscopy after standard pyloroplasty (40% standard vs. 24% CS pyloroplasty, P = 0.004), but the frequency of pyloric dilatation was similar. There were no leaks with either technique. A circular stapled pyloroplasty is as efficacious as a standard pyloroplasty after esophagectomy with gastric pull-up. Potential advantages include the ease and simplicity of the procedure along with virtually no risk of a leak and no graft shortening. The technique is amenable to both open and minimally invasive procedures.
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Details
- Title
- Circular stapled pyloroplasty: a fast and effective technique for pyloric disruption during esophagectomy with gastric pull-up
- Creators
- A. Oezcelik - University of Southern CaliforniaS. R. DeMeester - University of Southern CaliforniaK. Hindoyan - University of Southern CaliforniaJ. M. Leers - University of Southern CaliforniaS. Ayazi - University of Southern CaliforniaE. Abate - University of Southern CaliforniaJ. Zehetner - University of Southern CaliforniaJ. A. Hagen - University of Southern CaliforniaJ. C. Lipham - University of Southern CaliforniaT. R. DeMeester - University of Southern California
- Publication Details
- Diseases of the esophagus, v 24(6), pp 423-429
- Publisher
- Oxford Univ Press
- Number of pages
- 7
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Surgery
- Web of Science ID
- WOS:000293976400008
- Scopus ID
- 2-s2.0-80051676873
- Other Identifier
- 991022048375004721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Gastroenterology & Hepatology