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Article: Pyloroplasty versus no drainage in gastric replacement of the esophagus

TitlePyloroplasty versus no drainage in gastric replacement of the esophagus
Authors
Issue Date1991
PublisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/amjsurg
Citation
American Journal Of Surgery, 1991, v. 162 n. 5, p. 447-452 How to Cite?
AbstractIn a prospective randomized study of pyloroplasty versus no drainage, 200 patients (100 in each group) in whom the whole stomach was used for reconstruction following resection for esophageal carcinoma were studied. Only patients who underwent the Lewis-Tanner operation and who had a normal pylorus were included. There was no morbidity from the pyloroplasty procedure. Thirteen patients without drainage developed symptoms of gastric outlet obstruction, requiring prolonged postoperative parenteral nutrition, and reoperation was required in one patient. Four patients developed pulmonary complications associated with gastric distension, which resulted in fatal aspiration in two patients. Five patients had symptoms of outlet obstruction with eating at the time of their death. Mean and standard deviation of daily gastric aspirate was 161 ± 88 mL in the pyloroplasty group and 233 ± 142 mL for the control group (p = 0.23). Gastric emptying test showed mean T 1/2 ± standard deviation of 6.6 ± 7.5 minutes in the pyloroplasty group and 24.3 ± 31.5 minutes in the control group (p <0.001). More patients in the pyloroplasty group were able to tolerate a solid diet and at normal or increased amounts than were patients in the control group in the early postoperative weeks (p <0.01). In addition, control patients were found to have increased symptoms with meals, which were more frequent and of greater severity than symptoms in patients in the pyloroplasty group, even at 6 months after surgery (p <0.01). Therefore, we recommend a pyloroplasty for patients in whom the whole stomach is used for reconstruction after esophagectomy.
Persistent Identifierhttp://hdl.handle.net/10722/172638
ISSN
2015 Impact Factor: 2.403
2015 SCImago Journal Rankings: 1.286
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorFok, Men_US
dc.contributor.authorCheng, SWKen_US
dc.contributor.authorWong, Jen_US
dc.date.accessioned2012-10-30T06:23:57Z-
dc.date.available2012-10-30T06:23:57Z-
dc.date.issued1991en_US
dc.identifier.citationAmerican Journal Of Surgery, 1991, v. 162 n. 5, p. 447-452en_US
dc.identifier.issn0002-9610en_US
dc.identifier.urihttp://hdl.handle.net/10722/172638-
dc.description.abstractIn a prospective randomized study of pyloroplasty versus no drainage, 200 patients (100 in each group) in whom the whole stomach was used for reconstruction following resection for esophageal carcinoma were studied. Only patients who underwent the Lewis-Tanner operation and who had a normal pylorus were included. There was no morbidity from the pyloroplasty procedure. Thirteen patients without drainage developed symptoms of gastric outlet obstruction, requiring prolonged postoperative parenteral nutrition, and reoperation was required in one patient. Four patients developed pulmonary complications associated with gastric distension, which resulted in fatal aspiration in two patients. Five patients had symptoms of outlet obstruction with eating at the time of their death. Mean and standard deviation of daily gastric aspirate was 161 ± 88 mL in the pyloroplasty group and 233 ± 142 mL for the control group (p = 0.23). Gastric emptying test showed mean T 1/2 ± standard deviation of 6.6 ± 7.5 minutes in the pyloroplasty group and 24.3 ± 31.5 minutes in the control group (p <0.001). More patients in the pyloroplasty group were able to tolerate a solid diet and at normal or increased amounts than were patients in the control group in the early postoperative weeks (p <0.01). In addition, control patients were found to have increased symptoms with meals, which were more frequent and of greater severity than symptoms in patients in the pyloroplasty group, even at 6 months after surgery (p <0.01). Therefore, we recommend a pyloroplasty for patients in whom the whole stomach is used for reconstruction after esophagectomy.en_US
dc.languageengen_US
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/amjsurgen_US
dc.relation.ispartofAmerican Journal of Surgeryen_US
dc.subject.meshDeglutition - Physiologyen_US
dc.subject.meshDiatrizoate Meglumine - Diagnostic Useen_US
dc.subject.meshDrainageen_US
dc.subject.meshEating - Physiologyen_US
dc.subject.meshEsophageal Neoplasms - Surgeryen_US
dc.subject.meshEsophagectomyen_US
dc.subject.meshFemaleen_US
dc.subject.meshFollow-Up Studiesen_US
dc.subject.meshGastric Emptyingen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshPostoperative Complicationsen_US
dc.subject.meshProspective Studiesen_US
dc.subject.meshPylorus - Surgeryen_US
dc.subject.meshStomach - Physiopathology - Surgeryen_US
dc.titlePyloroplasty versus no drainage in gastric replacement of the esophagusen_US
dc.typeArticleen_US
dc.identifier.emailCheng, SWK: wkcheng@hkucc.hku.hken_US
dc.identifier.authorityCheng, SWK=rp00374en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1016/0002-9610(91)90258-Fen_US
dc.identifier.pmid1951907-
dc.identifier.scopuseid_2-s2.0-0025789605en_US
dc.identifier.volume162en_US
dc.identifier.issue5en_US
dc.identifier.spage447en_US
dc.identifier.epage452en_US
dc.identifier.isiWOS:A1991GR45400006-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridFok, M=7005879262en_US
dc.identifier.scopusauthoridCheng, SWK=7404684779en_US
dc.identifier.scopusauthoridWong, J=7404435808en_US

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