title: Botulinum toxin for prevention of delayed gastric emptying after esophagectomy.
abstract: BACKGROUND
  Esophageal cancer is among the most common gastrointestinal cancers for which the main treatment is surgery. This study was undertaken to analyze the results of Botox injection in preventing gastric stasis in these patients.
  
  
  METHODS
  60 patients with esophageal cancer in the middle and lower third parts were included in our study between 2010 and 2011, and were randomly divided into two groups. In group A, 30 patients underwent pyloroplasty, and in group B, injection of botulinum toxin into the pyloric sphincter muscle was used in 30 patients.
  
  
  RESULTS
  The mean age of these patients was 61 ± 10.7 years and the male/female ratio was 33:27. Isotope scans 3 weeks after surgery showed that 5 patients in group A and 3 in group B had delayed gastric emptying; there was no significant difference between the 2 groups, and the success rate of Botox injection was 90%.
  
  
  CONCLUSIONS
  Considering the fact that there was no significant difference between pyloroplasty and Botox injection on gastric emptying after surgery, and given the need to use less-aggressive techniques and facilitate greater use of endoscopic methods, botulinum toxin injection may be used instead of pyloroplasty as a simple, effective, and complication-free method to prevent delayed gastric emptying.
authors.affiliation: Cardiothoracic Surgery and Transplant Research Center, Emam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Bagheri
authors.forename: Seyed Hossein
authors.initials: SH
authors.lastname: Fattahi
authors.forename: Seyed Ziaollah
authors.initials: SZ
authors.lastname: Haghi
authors.forename: Kamran
authors.initials: K
authors.lastname: Aryana
authors.forename: Ali
authors.initials: A
authors.lastname: Aryanniya
authors.forename: Saeed
authors.initials: S
authors.lastname: Akhlaghi
authors.forename: Fateme Naghavi
authors.initials: FN
authors.lastname: Riyabi
authors.forename: Shima
authors.initials: S
authors.lastname: Sheibani
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects*; D005260:Female; D005746:Gastric Emptying / Q000187:drug effects*; D005765:Gastrointestinal Agents / Q000008:administration & dosage*; D018589:Gastroparesis / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D006801:Humans; D007273:Injections, Intramuscular; D007492:Iran; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D005765:Gastrointestinal Agents; D019274:Botulinum Toxins, Type A
keywords: Botulinum toxins; Esophageal neoplasms; Esophagectomy; Gastric emptying; Pylorus