Endoscopic Management of post-Esophagectomy De-layed-Gastric-Conduit-Emptying (DGCE): results from a Cohort Study in a Tertiary Referral Center with Comparison Between Procedures
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Aims Delayed Gastric Conduit Emptying (DGCE) occurs in 15–39% of patients who underwent esophagectomy. Intra-Pyloric Injection of Botulinum Toxin (IPBT), Pneumatic Balloon Dilation (PBD), and the same session combination (BTPD), represent the main endoscopic procedures, but comparative data are currently unavailable [ 1 ]. Methods We retrospectively analyzed prospectively collected data on all consecutive patients with DGCE treated endoscopically with IPBT, PBD, or BTPD. ISDE Diagnostic Criteria were used for DGCE diagnosis and classification. Gastric Outlet Obstruction Score was used for clinical staging. All patients undergoing IPBT received 100 UI of toxin, while those undergoing PBD were dilated up to 20mm. Clinical success (CS) was defined as the resolution of symptoms/resumption of feeding at discharge or expanding dietary intake at any rate. Recurrence was defined as symptom relapse after more than 15 days of well-being requiring endoscopic/surgical intervention. Results 64 patients (81.2% male, 90.6% Ivor-Lewis esophagectomy, 77.4% adenocarcinoma), median age 62 years (IQR 55-70), were enrolled: 18 (28.1%) in the IPBT group, 24 (37.5%) in the PBD group and 22 (34.4%) in the BTPD group. No statistically significant differences were found in the baseline characteristics, surgical techniques, and median follow-up among the three groups. BTPD showed a higher CS rate (100%) compared to the PD and BTPD groups (p=0.02) and Kaplan-Meier analysis with log-rank test revealed that the BTPD group was associated both with a significatively shorter mean time to refeed of 1.16 days (95% CI 0.8-1.5; p=0.001) and a shorter median time to discharge of 1 day (95% CI 1-3; p=0.0001). Conclusions Endoscopic management of DGCE remains challenging. Waiting for further strong evidence, BTPD can offer patients a higher clinical efficacy rate and a shorter time to refeed and be discharged. Publication History Article published online: 27 March 2025 © 2025. European Society of Gastrointestinal Endoscopy. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Endoscopic Management of post-Esophagectomy De-layed-Gastric-Conduit-Emptying (DGCE): results from a Cohort Study in a Tertiary Referral Center with Comparison Between Procedures
- Date Crossref
- 01/03/2025
- Éditeur
- Georg Thieme Verlag KG
- Type
- proceedings-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Vita-Salute San Raffaele University pays non établi dans la noticeUniversité ou école supérieure
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IRCCS Policlinico San Donato Gastroenterology and Gastrointestinal Endoscopy pays non établi dans la noticeÉtablissement de santé
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Istituti di Ricovero e Cura a Carattere Scientifico pays non établi dans la noticeÉtablissement de santé
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Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele pays non établi dans la noticeÉtablissement de santé
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IRCCS Azienda Ospedliero-Universitaria di Bologna Policlinico di Sant'Orsola pays non établi dans la noticeÉtablissement de santé
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IRCCS San Raffaele Scientific Institute Gastroenterology and Gastrointestinal Endoscopy pays non établi dans la noticeStructure de recherche
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S. Orsola-Malpighi Hospital Department of Medical and Surgical Sciences pays non établi dans la noticeÉtablissement de santé
Vita-Salute San Raffaele University, Gastroenterology and Gastrointestinal Endoscopy — IRCCS Policlinico San Donato et Istituti di Ricovero e Cura a Carattere Scientifico, avec 4 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.