Evaluation of the Role of Performing Pylorus Draining Procedure on the Outcomes Following Esophageal Resection

Daoud, Ahmed Mahmoud; Elhamami, Moustafa; Abu Arab, Walid

doi:10.21608/zumj.2025.384520.3948

Evaluation of the Role of Performing Pylorus Draining Procedure on the Outcomes Following Esophageal Resection

Document Type : Original Article

Authors

Cardiothoracic Surgery Department, Faculty of Medicine, Alexandria University

10.21608/zumj.2025.384520.3948

Abstract

Background

Delayed stomach emptying and stomach outlet obstruction are one of the most annoying complications that usually occur after esophagectomy as the procedure usually entails bilateral vagotomy which affects gastric motility after surgery.

Impaired stomach motility was found to increase the risk of having postoperative anastomotic leakage and aspiration pneumonia after esophagectomy.

The main aim of our study is to evaluate the role of pyloric drainage on the clinical outcome of the patients who received esophagectomy

Methods

The study is a prospective clinical study that included all patients who received esophagectomy for esophageal cancer at cardiothoracic surgery department, Alexandria University, Alexandria, Egypt during the period from January 2020 to January 2024.

Patients were divided into 2 groups according to whether they received pyloric drainage procedure or not and this was mainly decided according to surgeon preference.

Results

Regarding the presence of postoperative anastomotic leakage, there was no statistically significant difference between both groups as the incidence of leakage in group A was 12.5%, while in group B it was 14.3%.

Three patients in group A (18.8%) were suffering from manifestations of delayed gastric emptying and evaluation by oral contrast study and upper GIT endoscopy revealed that one of them was suffering from bile reflux.

Conclusion

Performing a prophylactic surgical pyloric drainage procedure esophagectomy may be unnecessary as there was no significant difference regarding persistent symptoms of delayed gastric emptying, anastomotic leakage and pulmonary complications in other patients who received esophagectomy without surgical pyloric drainage.

Keywords