{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T13:53:37Z","timestamp":1791640417916,"version":"4.3.4"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2021,9,2]],"date-time":"2021-09-02T00:00:00Z","timestamp":1630540800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,6,15]]},"abstract":"<jats:title>SUMMARY<\/jats:title>\n               <jats:p>Background: Early delayed gastric emptying (DGE) occurs in up to 50% of patients following oesophagectomy, which can contribute to increased anastomotic leak and respiratory infection rates. Although the treatment of DGE in the form of pyloric balloon dilatation (PBD) post-operatively is well established, there is no consensus on the optimal approach in the prevention of DGE. The aim of this review was to determine the efficacy of prophylactic PBD in the prevention of DGE following oesophagectomy. Method: PubMed, MEDLINE and the Cochrane Library (January 1990 to April 2021) were searched for studies reporting the outcomes of prophylactic PBD in patients who underwent oesophagectomy. The primary outcome measure was the rate of DGE. Secondary outcome measures include anastomotic leak rate and length of hospital stay. Results: Three studies with a total of 203 patients [mean age 63 (26\u201382) years, 162 males (79.8%)] were analyzed. PBD with a 20-mm balloon was performed in 165 patients (46 patients had PBD and botox therapy) compared with 38 patients who had either no intervention or botox alone (14 patients). The pooled rates of early DGE [16.27%, 95% CI (12.29\u201320.24) vs. 39.02% (38.87\u201339.17) (P\u2009&amp;lt;\u20090.001)] and anastomotic leak [8.55%, 95% CI (8.51\u20138.59) vs. 12.23% (12.16\u201312.31), P\u2009&amp;lt;\u20090.001] were significantly lower in the PBD group. Conclusion: Prophylactic PBD with a 20-mm balloon significantly reduced the rates of early delayed gastric emptying and anastomotic leak following oesophagectomy.<\/jats:p>","DOI":"10.1093\/dote\/doab062","type":"journal-article","created":{"date-parts":[[2021,9,6]],"date-time":"2021-09-06T15:18:53Z","timestamp":1630941533000},"source":"Crossref","is-referenced-by-count":8,"title":["Systematic review and meta-analysis of the influence of prophylactic pyloric balloon dilatation in the prevention of early delayed gastric emptying after oesophagectomy"],"prefix":"10.1093","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8794-6450","authenticated-orcid":false,"given":"Mohamed","family":"Abdelrahman","sequence":"first","affiliation":[{"name":"Department of Upper GI Surgery , Derriford Hospital, Plymouth, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arun","family":"Ariyarathenam","sequence":"additional","affiliation":[{"name":"Department of Upper GI Surgery , Derriford Hospital, Plymouth, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Berrisford","sequence":"additional","affiliation":[{"name":"Department of Upper GI Surgery , Derriford Hospital, Plymouth, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee","family":"Humphreys","sequence":"additional","affiliation":[{"name":"Department of Upper GI Surgery , Derriford Hospital, Plymouth, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grant","family":"Sanders","sequence":"additional","affiliation":[{"name":"Department of Upper GI Surgery , Derriford Hospital, Plymouth, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Wheatley","sequence":"additional","affiliation":[{"name":"Department of Upper GI Surgery , Derriford Hospital, Plymouth, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David S Y","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Upper GI Surgery , Derriford Hospital, Plymouth, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,9,2]]},"reference":[{"key":"2022061508240649900_ref1","doi-asserted-by":"crossref","first-page":"1512","DOI":"10.1016\/j.athoracsur.2014.06.057","article-title":"Surgical techniques to prevent delayed gastric emptying after esophagectomy with gastric interposition: a systematic review","volume":"98","author":"Akkerman","year":"2014","journal-title":"Ann Thorac Surg"},{"key":"2022061508240649900_ref2","doi-asserted-by":"crossref","first-page":"S835","DOI":"10.21037\/jtd.2018.11.80","article-title":"Delayed emptying of the gastric conduit after esophagectomy","volume":"11","author":"Konradsson","year":"2019","journal-title":"J Thorac Dis"},{"key":"2022061508240649900_ref3","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.1093\/dote\/doz074","article-title":"Diagnostic criteria and symptom grading for delayed gastric conduit emptying after esophagectomy for cancer: international expert consensus based on a modified Delphi process","volume":"33","author":"Konradsson","year":"2020","journal-title":"Dis Esophagus"},{"key":"2022061508240649900_ref4","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1111\/dote.12191","article-title":"The impact of pyloric drainage on clinical outcome following esophagectomy: a systematic review","volume":"28","author":"Arya","year":"2015","journal-title":"Dis Esophagus"},{"key":"2022061508240649900_ref5","doi-asserted-by":"crossref","first-page":"1512","DOI":"10.1093\/dote\/doy112","article-title":"Intraoperative pyloric botulinum toxin injection during Ivor-Lewis gastroesophagectomy to prevent delayed gastric emptying","volume":"32","author":"Tham","year":"2019","journal-title":"Dis Esophagus"},{"key":"2022061508240649900_ref6","doi-asserted-by":"crossref","first-page":"2023","DOI":"10.1007\/s00464-012-2151-5","article-title":"Endoscopic pyloric balloon dilatation obviates the need for pyloroplasty at esophagectomy","volume":"26","author":"Swanson","year":"2012","journal-title":"Surg Endosc"},{"key":"2022061508240649900_ref7","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1093\/dote\/doy097","article-title":"Preoperative endoscopic pyloric balloon dilatation decreases the rate of delayed gastric emptying after Ivor-Lewis esophagectomy","volume":"32","author":"Hadzijusufovic","year":"2019","journal-title":"Dis Esophagus"},{"key":"2022061508240649900_ref8","doi-asserted-by":"crossref","first-page":"37","DOI":"10.21037\/shc.2020.02.07","article-title":"Gastric emptying after esophagectomy: comparing single therapy versus dual therapy method for pyloric drainage","volume":"4","author":"Decker","year":"2020","journal-title":"Shanghai Chest"},{"key":"2022061508240649900_ref9","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"2022061508240649900_ref10","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1007\/s10654-010-9491-z","article-title":"Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses","volume":"25","author":"Stang","year":"2010","journal-title":"Eur J Epidemiol"},{"key":"2022061508240649900_ref11","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1016\/j.athoracsur.2010.12.055","article-title":"Management of delayed gastric emptying after esophagectomy with endoscopic balloon dilatation of the pylorus","volume":"91","author":"Lanuti","year":"2011","journal-title":"Ann Thorac Surg"},{"key":"2022061508240649900_ref12","doi-asserted-by":"crossref","first-page":"302","DOI":"10.21037\/jtd.2018.11.101","article-title":"Management of delayed gastric conduit emptying after esophagectomy","volume":"11","author":"Zhang","year":"2019","journal-title":"J Thorac Dis"},{"key":"2022061508240649900_ref13","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/dote\/doy038","article-title":"Effects of intraoperative pyloric stretch procedure on outcomes after esophagectomy","volume":"31","author":"Boshier","year":"2018","journal-title":"Dis Esophagus"},{"key":"2022061508240649900_ref14","doi-asserted-by":"crossref","first-page":"2405","DOI":"10.1007\/s00268-016-3575-1","article-title":"Gastric outlet obstruction after Esophagectomy: retrospective analysis of the effectiveness and safety of postoperative endoscopic pyloric dilatation","volume":"40","author":"Maus","year":"2016","journal-title":"World J Surg Springer International Publishing"},{"key":"2022061508240649900_ref15","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1111\/j.1442-2050.2008.00809.x","article-title":"Prognostic significance of failure to cross esophageal tumors by endoluminal ultrasound","volume":"21","author":"Morgan","year":"2008","journal-title":"Dis Esophagus"},{"key":"2022061508240649900_ref16","first-page":"1","article-title":"The CBDO, 2018. A comparison of the left thoracoabdominal and Ivor\u2013Lewis esophagectomy","volume":"31","author":"Davies","year":"2017","journal-title":"Dis Esophagus"}],"container-title":["Diseases of the Esophagus"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/dote\/article-pdf\/35\/6\/doab062\/44063644\/doab062.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/dote\/article-pdf\/35\/6\/doab062\/44063644\/doab062.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,6,15]],"date-time":"2022-06-15T08:24:25Z","timestamp":1655281465000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/dote\/article\/doi\/10.1093\/dote\/doab062\/6363055"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,2]]},"references-count":16,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2021,9,2]]},"published-print":{"date-parts":[[2022,6,15]]}},"URL":"https:\/\/doi.org\/10.1093\/dote\/doab062","relation":{},"ISSN":["1120-8694","1442-2050"],"issn-type":[{"value":"1120-8694","type":"print"},{"value":"1442-2050","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,6]]},"published":{"date-parts":[[2021,9,2]]},"article-number":"doab062"}}