The Clinical Analysis Of Delayed Gastric Emptying After Esophagectomy Resection

Objective To examine the relationship between the related factors and clinical features of delayed gastric emptying in postoperative patients with esophagectomy resection and provide theoretical basis for the clinical therapy and prophylaxis.Methods The data of patients with gastric esophageal tract reconstruction due to esophagectomy resection in the Union Hospital of Fujian Medical University from 1996 to 2010 were investigated retrospectively (n=973). Two groups were identified:those with known pre-existing delayed gastric emptying (Group A) and those without (Group B).Results The incidence of delayed gastric emptying after esophagectomy in 1682 patients with esophageal cancer was 1.84%. Of thirty-one patients with delayed gastric emptying; twenty-four had esophagectomy with cervical anastomosis; seven had intrathoracic anastomosis. The symptoms occurred in 4 to 36 days(average:12±2.4 days) after operation. The management included gastrointestinal decompression,nutritional support,gastric lavage,maintenance of hydroelectrolytic balance and application of prokinetic drugs. six cases accorded psychological intervention; two cases afforded pereutaneous endoscopic gastrostomy or jejunostomy. Of thirty-one cases of thoracic delayed gastric emptying in 29 patients cured by conservative treatment, two cases Self-discharge in one month after surgery and no deaths。After onset in all patients at 14-73 d, (average 26±4.3d) recovery of gastric function.Conclusions1. FDGE are more common in patients with high esophagogastric anastomosis and often developed in patients with esophagogastric cervical anastomosis. 2. The occurrence of FDGE have distinct connections with chronic gastritis; the method of surgical and the location of the anastomosis.3. Vagotomy and anatomic changes in the stomach are the main causes of FDGE.