Society for Surgery of the Alimentary Tract
SSAT Home SSAT Home Past & Future Meetings Past & Future Meetings

Back to 2023 Abstracts


ERAS GUIDELINES-DRIVEN UPPER GASTROINTESTINAL CONTRAST STUDY AFTER ESOPHAGECTOMY CAN DETECT DELAYED GASTRIC CONDUIT EMPTYING AND IMPROVE OUTCOMES
Taha M. Qaraqe*, Donald E. Low
General and Thoracic Surgery, Virginia Mason Medical Center, Seattle, WA

Background
Delayed gastric conduit emptying can occur after esophagectomy and has been shown to be associated with increased risk for postoperative complications. Application of a standardized clinical protocol after esophagectomy including an upper gastrointestinal contrast study has the potential to improve postoperative outcomes.

Methods
Prospective cohort including all patients operated with esophagectomy at two high-volume centers for esophageal surgery. The study included 119 patients of whom 112 (94.1%) completed an upper gastrointestinal contrast study. The standardized clinical protocol included an upper gastrointestinal contrast study on day 2 or 3 after surgery. All images were compiled and evaluated for the purpose of the study. Clinical data was collected in IRB-approved institutional databases at the participating centers.

Results
The results showed that 8 (7.1 %) patients had no emptying of contrast from the gastric conduit, partial emptying was seen in in 34 (30.4%) patients, and 70 (62.5%) patients had complete conduit emptying. Complete or partial emptying was associated with significantly earlier NG tube removal (3 vs. 6 days) and hospital discharge (8 vs. 17 days). Radiological signs of delayed gastric conduit emptying was shown to be associated with increased risk of postoperative complications and increased length of hospital stay. There was no association with severe postoperative complications, pulmonary complications or need for intensive care.

Conclusion
The results of the study demonstrate that postoperative upper gastrointestinal contrast studies can be used to assess the level of emptying of the gastric conduit after esophagectomy. Application of upper gastrointestinal contrast study in the ERAS guidelines-driven standardized clinical pathway after esophagectomy can improve postoperative outcomes.


Back to 2023 Abstracts