Is pyloroplasty necessary following intrathoracic transposition of stomach? Results of a prospective clinical study.

Twenty four patients underwent oesophagectomy for oesophageal cancer. The oesophagogastric anastomosis was performed in the neck in all patients. Following oesophagectomy and gastric mobilization patients were randomly selected into pyloroplasty and no pyloroplasty groups. Pre and postoperative gastric emptying of these patients evaluated by radioisotope technique were then compared. The results suggest significantly delayed postoperative gastric emptying in both the groups though it was less pronounced in the pyloroplasty group. All patients were then carefully followed until death (period varying between 6 months and 4 years) for ill effects of delayed gastric emptying which were present in some patients of both the groups. It was thus concluded that emptying of thoracic stomach is delayed and pyloroplasty fails to improve it completely. Postoperatively patients behave much the same way with or without pyloroplasty.