title: Whole stomach transposition without gastric drainage procedure: a good surgical option to restore digestive continuity after esophagectomy.
abstract: After esophagectomy, the stomach is usually used to restore digestive continuity. To prevent postoperative delayed gastric emptying, most authors perform a gastric drainage procedure or transpose a tubulized stomach. The aim of our work is to evaluate the emptying of a transposed whole stomach without performing a pyloromyotomy or a pyloroplasty. From 1996 to January 2004, 45 patients underwent total esophagectomy for cancer or for caustic stenosis. Reconstruction of digestive continuity was realized through transposition of the whole stomach without performing a pyloric drainage procedure. At 12 months after the intervention, 35 patients (77.8%; 20 men and 15 women) were submitted to a gastric emptying scintigraphic study by means of ingestion of a mixed meal labeled with 37 MBq 99mTc-sulfur colloid. Mean half-emptying time was 71.4 minutes (range, 15-90 minutes; reference range, 83 +/- 34 minutes): all the patients were in the normal range except one. No patient complained of delayed gastric emptying symptoms. After esophagectomy, the transposition of the whole stomach without a pyloric drainage procedure seems to be an interesting option, and is not associated with delayed gastric emptying.
authors.affiliation: I Division of General and Gastrointestinal Surgery, Second University of Naples, Naples, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Maffettone
authors.forename: Gianluca
authors.initials: G
authors.lastname: Rossetti
authors.forename: Pierfrancesco
authors.initials: P
authors.lastname: Rambaldi
authors.forename: Federica
authors.initials: F
authors.lastname: Russo
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Cuccurullo
authors.forename: Luigi
authors.initials: L
authors.lastname: Brusciano
authors.forename: Gianmattia
authors.initials: G
authors.lastname: del Genio
authors.forename: Gianluca
authors.initials: G
authors.lastname: Russo
authors.forename: Francesco
authors.initials: F
authors.lastname: Pizza
authors.forename: Luigi
authors.initials: L
authors.lastname: Mansi
authors.forename: Alberto
authors.initials: A
authors.lastname: del Genio
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D004322:Drainage; D004938:Esophageal Neoplasms / Q000601:surgery; D004940:Esophageal Stenosis / Q000601:surgery; D016629:Esophagectomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005746:Gastric Emptying / Q000502:physiology; D005766:Gastrointestinal Contents / Q000000981:diagnostic imaging; D005772:Gastrointestinal Transit / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011708:Pylorus; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D013270:Stomach / Q000601:surgery*; D013671:Technetium Tc 99m Sulfur Colloid; D013997:Time Factors
chemical_list: D019275:Radiopharmaceuticals; D013671:Technetium Tc 99m Sulfur Colloid