The Optimal Pyloric Procedure: A Collective Review
Vagal damage and subsequent pyloric denervation inevitably occur during esophagectomy, potentially leading to delayed gastric emptying (DGE). The choice of an optimal pyloric procedure to overcome DGE is important, as such procedures can lead to prolonged surgery, shortening of the conduit, disrupti...
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Published in | Journal of chest surgery Vol. 53; no. 4; pp. 233 - 241 |
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Main Author | |
Format | Journal Article |
Language | English |
Published |
The Korean Society for Thoracic and Cardiovascular Surgery
05.08.2020
Korean Society for Thoracic and Cardiovascular Surgery 대한흉부외과학회 |
Subjects | |
Online Access | Get full text |
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Summary: | Vagal damage and subsequent pyloric denervation inevitably occur during esophagectomy, potentially leading to delayed gastric emptying (DGE). The choice of an optimal pyloric procedure to overcome DGE is important, as such procedures can lead to prolonged surgery, shortening of the conduit, disruption of the blood supply, and gastric dumping/bile reflux. This study investigated various pyloric methods and analyzed comparative studies in order to determine the optimal pyloric procedure. Surgical procedures for the pylorus include pyloromyotomy, pyloroplasty, or digital fracture. Botulinum toxin injection, endoscopic balloon dilatation, and erythromycin are non-surgical procedures. The scope, technique, and effects of these procedures are changing due to advances in minimally invasive surgery and postoperative interventions. Some comparative studies have shown that pyloric procedures are helpful for DGE, while others have argued that it is difficult to reach an objective conclusion because of the variety of definitions of DGE and evaluation methods. In conclusion, recent advances in interventional technology and minimally invasive surgery have led to questions regarding the practice of pyloric procedures. However, many clinicians still perform them and they are at least somewhat effective. To provide guidance on the optimal pyloric procedure, DGE should first be defined clearly, and a large-scale study with an objective evaluation method will then be required. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 This article was presented at the 6th Esophageal Cancer Symposium (lecture on November 16th, 2019, Samsung Medical Center, Seoul, Korea). |
ISSN: | 2233-601X 2765-1606 2093-6516 2765-1614 |
DOI: | 10.5090/kjtcs.2020.53.4.233 |