title: Usefulness of Pyloromyotomy With Transhiatal Esophagectomy in Improving Gastric Emptying.
abstract: BACKGROUND
  Pyloromyotomy is a pyloric drainage procedure routinely done during transhiatal esophagectomy (THE) to prevent delayed gastric emptying (GE) resulting from truncal vagotomy. However, controversy still surrounds the need for pyloric drainage following esophageal substitution with gastric conduit after esophagectomy. The aim of this study was to determine the usefulness of pyloromyotomy in improving the postoperative gastric emptying time.
  
  
  METHODS
  Forty patients with esophageal cancer underwent THE. 20 patients underwent THE without pyloromyotomy (group A), while the other 20 patients (group B) underwent THE with pyloromyotomy. Using Technetium-99 m, gastric scintigraphy-using gamma camera, was done for all the patients 6 months post-surgery to measure the gastric half emptying time (T50).
  
  
  RESULTS
  For the liquid phase, the mean (T50) in the patients without pyloromytomy (group A) was 74.5 ± 56.71 minutes ± SD versus 62.85 ± 59.35 minutes ± SD in the patients with pyloromytomy (group B) which is not significant (P = 0.529). For the solid phase, the mean (T50) in patients of group A was 139.40 ± 94.156 minutes ± SD versus 141.15 ± 48.423 minutes ± SD in group B (P value 0.941) which is also not significant.
  
  
  CONCLUSIONS
  Six months after THE, pyloromyotomy done with THE showed no significant value on affecting the mean gastric emptying time compared to those underwent THE without pyloromyotomy.
authors.affiliation: Department of Thoracic Surgery, Urmia University of Medical Sciences, Urmia, Iran.
authors.forename: Rahim
authors.initials: R
authors.lastname: Mahmodlou
authors.affiliation: Department of Surgery, Urmia University of Medical Sciences, Urmia, Iran.
authors.forename: Nazmohammad
authors.initials: N
authors.lastname: Badpa
authors.affiliation: Department of Anatomy, Sharjeh University of Medical Sciences, United Arab Emirates.
authors.forename: Emad
authors.initials: E
authors.lastname: Nosair
authors.affiliation: Department of Nuclear Medicine, Urmia University of Medical Sciences, Urmia, Iran.
authors.forename: Hojat
authors.initials: H
authors.lastname: Shafipour
authors.affiliation: Student Research Center (SRC), Urmia University of Medical Sciences, Urmia, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Ghasemi-Rad
keywords: Gastric emptying; Pyloromyotomy; Transhiatal esophagectomy