Delayed emptying of the gastric conduit after esophagectomy

Abstract

With increasing survival after esophagectomy for cancer, a growing number of individuals living with the functional results of a surgically altered anatomy calls for attention to the effects of delayed gastric conduit emptying (DGCE) on health-related quality of life and nutritional impairment. We here give an overview of the currently available literature on DGCE, in terms of epidemiology, pathophysiology, diagnostics, prevention and treatment. Attention is given to controversies in the current literature and obstacles related to general applicability of study results, as well as knowledge gaps that may be the focus for future research initiatives. Finally, we propose that measures are taken to reach international expert agreement regarding diagnostic criteria and a symptom grading tool for DGCE, and that functional radiological methods are established for the diagnosis and severity grading of DGCE.

Keywords: Delayed gastric emptying; balloon dilatation; botulinum toxin; esophageal cancer; esophagectomy; functional disorders; gastric conduit; gastric emptying; gastric outlet obstruction; pyloromyotomy; pyloroplasty; pylorus.