Conduit size and the risk of delayed gastric conduit emptying after esophagectomy
- 1Department of Gastroenterological Surgery and Pediatric Surgery, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu City, 501-1194 Gifu Prefecture Japan
- 2Department of Clinical Anatomy Development Studies, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu City, 501-1194 Gifu Prefecture Japan
Abstract
Purposes: Delayed gastric conduit emptying (DGCE) is a frequent complication after esophagectomy that affects nutrition and the quality of life. Subtotal gastric conduit (STG) and wide gastric conduit (WG) reconstructions are commonly performed. This study assessed whether WG reduces DGCE compared to STG.
Methods: We retrospectively reviewed 169 patients who underwent posterior mediastinal gastric reconstruction between January 2019 and December 2024. Patients who underwent Ivor-Lewis procedures and non-gastric reconstructions were excluded. The conduits were classified as STG or WG based on the stapler firings. The resected gastric length and maximal diameter were measured. The outcomes included DGCE, anastomotic complications, pneumonia, weight loss, serum albumin, hemoglobin, and psoas muscle index (PMI). Appropriate statistical tests were performed.
Results: Of the 169 patients, 128 underwent STG and 41 underwent WG reconstruction. The baseline characteristics were similar, although the WG group included more female patients and had a higher BMI. The resected gastric length was shorter in the STG (p < 0.001), whereas the conduit length tended to be longer (p = 0.051). No significant differences were observed in terms of DGCE, anastomotic leakage, pneumonia, weight loss, PMI, or albumin levels. Hemoglobin at 1 year was slightly lower in WG (10.2 vs. 11.1 g/dL, p = 0.002).
Conclusions: WG reconstruction did not reduce DGCE or other complications compared with STG reconstruction. The gastric conduit size alone may not prevent DGCE. Further studies are warranted to explore surgical strategies for improving postoperative gastric emptying.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s00595-026-03395-w.
Related
- Contemporary international practice patterns in the prevention, diagnosis, and management of delayed gastric conduit emptying after oesophagectomy: an international survey of oesophagogastric surgeons.
- Endoscopic accessibility and conduit passage after retrosternal vs. posterior mediastinal gastric conduit reconstruction following McKeown esophagectomy: a retrospective cohort study
- Appetite Suppression by GLP ‐1 Receptor Agonists: Role of Delayed Gastric Emptying
- Delayed Gastric Emptying Is Associated With Progression to End-Stage Renal Disease in Diabetic Patients With Chronic Upper Gastrointestinal Symptoms
- Severe delayed gastric emptying combined with enteroparalysis after pancreaticoduodenectomy: a case report
BibTeX
@article{sato2026conduit,
title = {{Conduit size and the risk of delayed gastric conduit emptying after esophagectomy}},
author = {Yuta Sato and Yoshihiro Tanaka and Yuji Hatanaka and Seito Fujibayashi and Noriki Mitsui and Ryoma Yokoi and Takeshi Horaguchi and Keita Matsumoto and Masahiro Fukada and Itaru Yasufuku and Ryuichi Asai and Jesse Yu Tajima and Nobuhisa Matsuhashi},
journal = {Surgery Today},
year = {2026},
month = jul,
doi = {10.1007/s00595-026-03395-w},
url = {https://doi.org/10.1007/s00595-026-03395-w},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Conduit size and the risk of delayed gastric conduit emptying after esophagectomy
AU - Yuta Sato
AU - Yoshihiro Tanaka
AU - Yuji Hatanaka
AU - Seito Fujibayashi
AU - Noriki Mitsui
AU - Ryoma Yokoi
AU - Takeshi Horaguchi
AU - Keita Matsumoto
AU - Masahiro Fukada
AU - Itaru Yasufuku
AU - Ryuichi Asai
AU - Jesse Yu Tajima
AU - Nobuhisa Matsuhashi
PY - 2026
DA - 2026/07/14
JO - Surgery Today
DO - 10.1007/s00595-026-03395-w
UR - https://doi.org/10.1007/s00595-026-03395-w
AB - Purposes: Delayed gastric conduit emptying (DGCE) is a frequent complication after esophagectomy that affects nutrition and the quality of life. Subtotal gastric conduit (STG) and wide gastric conduit (WG) reconstructions are commonly performed. This study assessed whether WG reduces DGCE compared to STG. Methods: We retrospectively reviewed 169 patients who underwent posterior mediastinal gastric reconstruction between January 2019 and December 2024. Patients who underwent Ivor-Lewis procedures and non-gastric reconstructions were excluded. The conduits were classified as STG or WG based on the stapler firings. The resected gastric length and maximal diameter were measured. The outcomes included DGCE, anastomotic complications, pneumonia, weight loss, serum albumin, hemoglobin, and psoas muscle index (PMI). Appropriate statistical tests were performed. Results: Of the 169 patients, 128 underwent STG and 41 underwent WG reconstruction. The baseline characteristics were similar, although the WG group included more female patients and had a higher BMI. The resected gastric length was shorter in the STG (p < 0.001), whereas the conduit length tended to be longer (p = 0.051). No significant differences were observed in terms of DGCE, anastomotic leakage, pneumonia, weight loss, PMI, or albumin levels. Hemoglobin at 1 year was slightly lower in WG (10.2 vs. 11.1 g/dL, p = 0.002). Conclusions: WG reconstruction did not reduce DGCE or other complications compared with STG reconstruction. The gastric conduit size alone may not prevent DGCE. Further studies are warranted to explore surgical strategies for improving postoperative gastric emptying. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s00595-026-03395-w.
SN - 0941-1291
SN - 1436-2813
ER -