Contemporary international practice patterns in the prevention, diagnosis, and management of delayed gastric conduit emptying after oesophagectomy: an international survey of oesophagogastric surgeons.
12 affiliations
- 1Department of Surgery, The University of Melbourne, Melbourne, Victoria 3010, Australia.
- 2Department of Upper Gastrointestinal Surgery, St Vincent's Hospital Melbourne, 41 Victoria Parade, Fitzroy, Victoria 3065, Australia.
- 3Division of Cancer Surgery, Peter MacCallum Cancer Centre, Victorian Comprehensive Cancer Centre, 305 Grattan Street, Melbourne, Victoria 3000, Australia.
- 4Imperial College London, Exhibition Road, South Kensington, London SW7 2AZ, UK.
- 5Department of Surgery, National Cancer Institute, Cairo University, 1 Kasr Al-Ainy Street, Cairo 11796, Egypt.
- 6Department of Surgery, Leicester Royal Infirmary, Infirmary Square, Leicester, Leicestershire LE1 5WW, UK.
- 7Department of Upper Gastrointestinal Surgery, The James Cook University Hospital, Marton Road, Middlesbrough, Cleveland TS4 3BW, UK.
- 8Division of Surgery, Northern Health, Northern Hospital Epping, 185 Cooper Street, Epping, Victoria 3076, Australia.
- 9Upper Gastrointestinal Surgery Unit, Austin Hospital, 145 Studley Road, Heidelberg, Victoria 3084, Australia.
- 10Victorian Interventional Research and Trials Unit, Department of Surgery, The University of Melbourne, Austin Health, 145 Studley Road, Heidelberg, Victoria 3084, Australia.
- 11The Sir Peter MacCallum Department of Oncology, The University of Melbourne, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, Victoria 3000, Australia.
- 12National Oesophageal and Gastric Centre, St James's Hospital and Trinity College Dublin, James's Street, Dublin 8, D08 NHY1, Ireland.
Abstract
Delayed gastric conduit emptying (DGCE) is a common functional complication after oesophagectomy, yet it remains inconsistently defined and managed. Although consensus diagnostic criteria are available, their incorporation into routine audit and the contemporary international patterns of DGCE-related practice have not been characterized. This study aimed to describe current international practice in the prevention, diagnosis and management of DGCE. A cross-sectional online survey was developed and distributed to surgeons performing oesophagectomy internationally through The Upper Gastrointestinal Surgical Society. The 55-item instrument captured practice patterns and perceptions relating to DGCE across the perioperative care pathway and during follow-up. Associations were assessed using Pearson chi-square and Fisher's exact tests. Two hundred and thirty surgeons from 57 countries responded. Fewer than one in five documented early (19.1%) or late (19.6%) DGCE using a standardized audit definition, and incidence was commonly perceived to be less than 10% for both. Prophylactic pyloric intervention was reported by 61.7% of respondents and varied significantly by operative platform, being more frequent among open and hybrid surgeons than minimally invasive or robotic surgeons (P = 0.013). Management of established DGCE was highly variable, with conservative and pharmacological measures predominating as first-line therapy and endoscopic pyloric interventions most commonly employed for refractory late DGCE. DGCE practice after oesophagectomy remains highly heterogeneous, shaped by institutional habit as much as by evidence. These findings support wider adoption of standardized DGCE definitions, incorporation of DGCE outcomes into institutional and national registries, and prospective trials comparing prophylactic pyloric strategies.
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BibTeX
@article{sivakumar2026contemporary,
title = {{Contemporary international practice patterns in the prevention, diagnosis, and management of delayed gastric conduit emptying after oesophagectomy: an international survey of oesophagogastric surgeons.}},
author = {Jonathan Sivakumar and Mohamed Abulazayem and Michael W Hii and Feras Alnimri and Alex Boddy and Yirupaiahgari K S Viswanath and Carlos Cabalag and David S Liu and Jessie A Elliott and Yogesh Vashist and Cuong P Duong and TUGSS Collaborative Group},
journal = {Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus},
year = {2026},
month = sep,
doi = {10.1093/dote/doag115},
url = {https://europepmc.org/article/MED/42900764},
note = {CC BY},
}
RIS
TY - JOUR
TI - Contemporary international practice patterns in the prevention, diagnosis, and management of delayed gastric conduit emptying after oesophagectomy: an international survey of oesophagogastric surgeons.
AU - Jonathan Sivakumar
AU - Mohamed Abulazayem
AU - Michael W Hii
AU - Feras Alnimri
AU - Alex Boddy
AU - Yirupaiahgari K S Viswanath
AU - Carlos Cabalag
AU - David S Liu
AU - Jessie A Elliott
AU - Yogesh Vashist
AU - Cuong P Duong
AU - TUGSS Collaborative Group
PY - 2026
DA - 2026/09/01
JO - Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
DO - 10.1093/dote/doag115
UR - https://europepmc.org/article/MED/42900764
AB - Delayed gastric conduit emptying (DGCE) is a common functional complication after oesophagectomy, yet it remains inconsistently defined and managed. Although consensus diagnostic criteria are available, their incorporation into routine audit and the contemporary international patterns of DGCE-related practice have not been characterized. This study aimed to describe current international practice in the prevention, diagnosis and management of DGCE. A cross-sectional online survey was developed and distributed to surgeons performing oesophagectomy internationally through The Upper Gastrointestinal Surgical Society. The 55-item instrument captured practice patterns and perceptions relating to DGCE across the perioperative care pathway and during follow-up. Associations were assessed using Pearson chi-square and Fisher's exact tests. Two hundred and thirty surgeons from 57 countries responded. Fewer than one in five documented early (19.1%) or late (19.6%) DGCE using a standardized audit definition, and incidence was commonly perceived to be less than 10% for both. Prophylactic pyloric intervention was reported by 61.7% of respondents and varied significantly by operative platform, being more frequent among open and hybrid surgeons than minimally invasive or robotic surgeons (P = 0.013). Management of established DGCE was highly variable, with conservative and pharmacological measures predominating as first-line therapy and endoscopic pyloric interventions most commonly employed for refractory late DGCE. DGCE practice after oesophagectomy remains highly heterogeneous, shaped by institutional habit as much as by evidence. These findings support wider adoption of standardized DGCE definitions, incorporation of DGCE outcomes into institutional and national registries, and prospective trials comparing prophylactic pyloric strategies.
SN - 1120-8694
SN - 1442-2050
ER -