Esophagectomy without Pyloroplasty or Pyloromyotomy

Esophageal cancer is one of the deadliest diseases in the world and in particular, has high prevalence in the north of the Iran. The main treatment for this condition is surgery. Because of necessity of vagotomy during esophagectomy, doing or not doing pyloroplasty or pyloromyotomy as a way to prevent delay in emptying the stomach (pyloric drainage), is controversial among surgeons. The aim of this study was to investigate the effects of esophagectomy without pyloroplasty or pyloromyotomy. In this prospective study, complications of esophagectomy without pyloromyotomy or pyloroplasty in 50 patients with esophageal cancer were reviewed. 50 patients, 24 women and 26 men, were enrolled, 92% with squamous cell carcinoma (SCC) and 8% with adenocarcinoma. Postoperative early complications included anastomosis leakage (2%), pleural effusion (10%), pneumothorax (4%), pneumonia (14%), cardiac arrhythmias (20%), delirium (4%), and recurrent nerve injury (8%). Late complications after surgery including delayed gastric emptying (34%), gastric outlet obstruction (GOO) (2%), dumping syndrome (6%), and anastomsis stenosis (18%). Based on our findings, esophagectomy without pyloroplasty not only did not increase the complications, but also could shorten the operation time. Therefore, esophagectomy can be performed without pyloroplasty or pyloromyotomy.