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Double tract-like gastric tube reconstruction decreases the incidences of delayed gastric emptying and bile reflux after esophagectomy: results of a pilot study of an experimental technique

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Abstract

Purpose

Esophagectomy with gastric tube reconstruction is often complicated postoperatively by duodenogastric reflux and/or delayed gastric emptying and the accompanying symptoms, leading to patients being dissatisfied with their quality of life (QOL). Medical interventions to relieve patients of their symptoms are rarely effective. We began, in 2018, performing double tract-like gastric tube reconstruction, and, in a pilot study, we compared postoperative QOL between patients in whom this experimental reconstruction was performed and those in whom conventional reconstruction was performed.

Methods

Included in the study were 33 patients who underwent thoracoscopic McKeown esophagectomy with two- or three-field lymph node dissection for thoracic esophageal cancer between April 2015 and March 2020. A gastric tube about 4 cm in width was created in all patients, and in 14 of the patients (DT group), a double tract was appended by anastomosing the elevated jejunum to the anterior wall of the gastric tube, QOL was assessed 10–14 months later by means of the DAUGS-32 questionnaire, and bile reflux and the presence or absence of food residue were assessed by upper gastrointestinal endoscopy.

Results

DAUGS-32 food passage dysfunction, nausea and vomiting, and reflux symptoms scores were significantly lower in the DT group than in the conventional reconstruction group. There was no significant between-group difference in the incidence of postoperative complications. No food residue was seen in DT patients’ gastric tube, and no reflux esophagitis was observed.

Conclusion

Double tract-like gastric tube reconstruction shows promise as an effective means of improving patients’ post-esophagectomy QOL.

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Data availability

The data used in this study includes the patient’s personal body and medical information. It is impossible to share the information because of the protection of the patient’s private information.

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Authors and Affiliations

  1. Department of Surgery, Teikyo University Hospital, Mizonokuchi, 5-1-1 Futako, Takatsu-ku, Kawasaki-city, Kanagawa, 213-8517, Japan

    Daisuke Fujimoto, Keizo Taniguchi, Junpei Takashima, Fumihiko Miura & Hirotoshi Kobayashi

Authors
  1. Daisuke Fujimoto
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  2. Keizo Taniguchi
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  3. Junpei Takashima
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  4. Fumihiko Miura
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  5. Hirotoshi Kobayashi
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Contributions

Daisuke Fujimoto: conceptualization, methodology, writing—original draft, visualization. Keizo Taniguchi: conceptualization, investigation. Junpei Takashima: formal analysis, resources, data curation. Fumihiko Miura: formal analysis, resources, data curation. Hirotoshi Kobayashi: validation, Writing—review and editing, supervision, projection administration, funding acquisition.

Corresponding author

Correspondence to Daisuke Fujimoto.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Ethical approval was obtained in all participating centers.

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Informed consent was obtained from all individual participants included in the study prior to recruitment.

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Not commissioned, externally peer-reviewed.

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The authors declare no competing interests.

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Fujimoto, D., Taniguchi, K., Takashima, J. et al. Double tract-like gastric tube reconstruction decreases the incidences of delayed gastric emptying and bile reflux after esophagectomy: results of a pilot study of an experimental technique. Langenbecks Arch Surg 407, 1431–1439 (2022). https://doi.org/10.1007/s00423-022-02461-4

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  • DOI: https://doi.org/10.1007/s00423-022-02461-4

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