Does pyloroplasty following esophagectomy improve early clinical outcomes?
A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed whether pyloroplasty following elective esophagectomy improves clinical outcomes. Altogether 170 relevant papers were identified using the below-mentioned search. One meta-analysis and six randomised controlled trials from the nine that were summarised in the meta-analysis represented the best evidence to answer the question. The author, journal, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses were tabulated. We conclude that pyloroplasty seems to reduce the incidence of gastric outlet obstruction and speed up gastric emptying. In addition, the incidence of complications from this procedure seems low. However, other significant improvements to outcomes such as mortality, nutrition, anastomotic leakage, gastric symptoms and aspiration are yet to be established.
Department of Cardiothoracic Surgery, Southampton General Hospital, UK.
Omar A
OA
Khan
James
J
Manners
Arvind
A
Rengarajan
Joel
J
Dunning
D000230:Adenocarcinoma / Q000503:physiopathology / Q000601:surgery*; D004322:Drainage / Q000009:adverse effects; D004938:Esophageal Neoplasms / Q000503:physiopathology / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects; D004943:Esophagogastric Junction / Q000601:surgery*; D005746:Gastric Emptying; D017219:Gastric Outlet Obstruction / Q000453:epidemiology / Q000209:etiology; D015391:Gastroplasty / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D015994:Incidence; D011708:Pylorus / Q000601:surgery*; D016896:Treatment Outcome