Surgical treatment of gastric outlet obstruction after corrosive injury--can early definitive operation be used instead of staged operation?
For the comparison of advantage and outcome, thirty six patients with corrosive upper GI injury resulting in only distal gastric outlet obstruction and failing to receive endoscopic balloon dilatation underwent prospective randomized different surgical treatments in the past years. Sixteen patients (Group A) received early definitive treatment with antrectomy or pyloroplasty for their gastric outlet obstruction, only 3 (18.8%) of them needed a second operation for the delayed esophageal stricture. The long-term follow-up for these patients revealed the stricture resolved after the antrectomy or pyloroplasty. All of the other 20 patients (Group B) who received gastrostomy plus feeding jejunostomy during their first operation required a second operation. Among the 20 patients receiving a second operation, delayed esophageal stricture was the reason in only 4 patients. It meant that 16 patients (80%) of Group B were able to avoid the second operation if early definitive treatment for their gastric outlet obstruction was performed during the first operation. We concluded that the early definitive treatment of gastric outlet obstruction can give patients a better quality of life, avoid a second operation in about 80% of them and save operative time in those who need a second operation for final esophageal reconstruction.
Hwang
T L
TL
Department of Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College, Taipei, Taiwan, ROC.
Chen
M F
MF
D002057:Burns, Chemical / Q000150:complications; D004064:Digestive System / Q000293:injuries; D005743:Gastrectomy; D017219:Gastric Outlet Obstruction / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007582:Jejunostomy; D011446:Prospective Studies; D011706:Pyloric Antrum / Q000601:surgery; D011708:Pylorus / Q000601:surgery; D013514:Surgical Procedures, Operative / Q000379:methods