{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T08:39:13Z","timestamp":1793090353557,"version":"4.5.0"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2022,9,8]],"date-time":"2022-09-08T00:00:00Z","timestamp":1662595200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100012921","name":"Royal College of Surgeons in Ireland","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012921","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,2,24]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Pyloroplasty or pyloromyotomy is often undertaken during esophagectomy to aid gastric emptying postoperatively. Minimally invasive esophagectomy (MIE) frequently omits a pyloric procedure. The impact on perioperative outcomes and the need for subsequent interventions is unclear. This study assesses the requirements for endoscopic balloon dilation of the pylorus (EPD) following MIE. Patients undergoing MIE from 2016 to 2020 were reviewed. Patients undergoing open resection, or an intraoperative pyloric procedure were excluded. Demographic, clinical and pathological data were reviewed. Univariable and multivariable analysis were performed as appropriate. In total, 171 patients underwent MIE. There were no differences in age (median 65 vs. 65\u00a0years, P\u00a0=\u20090.6), pathological stage (P\u00a0=\u20090.10) or ASA status (P\u00a0=\u20090.52) between those requiring and not requiring endoscopic pyloric dilation (EPD). Forty-three patients (25%) required EPD, with a total of 71 procedures. Twenty-seven patients (16%) had EPD on their index admission. Seventy-five patients (43%) had a postoperative complication. Higher ASA status was associated with increased requirement for EPD (odds ratio 10.8, P\u00a0=\u20090.03). On multivariable analysis, there was no association between the need for a pyloric procedure and overall survival (P\u00a0=\u20090.14). Eight patients (5%) required insertion of a feeding jejunostomy in the postoperative period, with no difference between those with or without EPD (P\u00a0=\u20090.11). Two patients required subsequent surgical pyloromyotomy for delayed gastric emptying. Although pyloroplasty or pyloromyotomy can safely be excluded during MIE, a quarter of patients will require postoperative EPD procedures. The impact of excluding pyloric procedures on gastric emptying requires further study.<\/jats:p>","DOI":"10.1093\/dote\/doac061","type":"journal-article","created":{"date-parts":[[2022,9,8]],"date-time":"2022-09-08T13:32:42Z","timestamp":1662643962000},"source":"Crossref","is-referenced-by-count":3,"title":["Omission of intraoperative pyloric procedures in minimally invasive esophagectomy: assessing the impact on patients"],"prefix":"10.1093","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0796-633X","authenticated-orcid":false,"given":"Jarlath C","family":"Bolger","sequence":"first","affiliation":[{"name":"Division of Thoracic Surgery, University Health Network , Toronto, ON , Canada"},{"name":"Department of Surgery, Royal College of Surgeons in Ireland , Dublin , Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harry","family":"Lau","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, University Health Network , Toronto, ON , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5759-3028","authenticated-orcid":false,"given":"Jonathan C","family":"Yeung","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, University Health Network , Toronto, ON , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gail E","family":"Darling","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, University Health Network , Toronto, ON , Canada"},{"name":"Department of Surgery, Dalhousie University , Halifax, NS , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,9,8]]},"reference":[{"issue":"2","key":"2023022503391648400_","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1016\/j.athoracsur.2019.08.019","article-title":"Using benchmarking standards to evaluate transition to minimally invasive 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Thorac Surg"},{"key":"2023022503391648400_","doi-asserted-by":"crossref","first-page":"754","DOI":"10.1007\/s00464-007-9225-9","article-title":"A pilot study of botulinum toxin injection for the treatment of delayed gastric emptying following esophagectomy","volume":"21","author":"Kent","year":"2007","journal-title":"Surg Endosc"},{"key":"2023022503391648400_","doi-asserted-by":"crossref","first-page":"doab062","DOI":"10.1093\/dote\/doab062","article-title":"Systematic review and meta-analysis of the influence of prophylactic pyloric balloon dilatation in the prevention of early delayed gastric emptying after oesophagectomy","volume":"35","author":"Abdelrahaman","year":"2022","journal-title":"Dis Esophagus"},{"key":"2023022503391648400_","doi-asserted-by":"crossref","first-page":"6777","DOI":"10.1007\/s00464-021-08962-5","article-title":"There is no correlation between a delayed gastric conduit emptying and the occurrence of an anastomotic leakage after Ivor Lewis 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