Damtoft Andreas, Osterkamp Jens, Olsen August A, De Heer Pieter, Achiam Michael Patrick
Department of Digestive Diseases, Transplantation and General Surgery, Rigshospitalet, Copenhagen University Hospital, Denmark.
Department of Clinical Medicine, University of Copenhagen, Denmark.
Dis Esophagus. 2025 May 3;38(3). doi: 10.1093/dote/doaf040.
Delayed gastric conduit emptying (DGCE) after esophagectomy is a major cause of morbidity and reduced quality of life. The reported incidence varies greatly (2.2-47%), partly due to a lack of consensus on the definition of DGCE. Recently, an international expert consensus proposed diagnostic criteria for Early-DGCE (E-DGCE) and Late-DGCE (L-DGCE) alongside a symptom severity score. Using these criteria, we investigated the incidence and predictors of DGCE in a large cohort. All patients undergoing esophagectomy with pyloroplasty at Rigshospitalet, Denmark, between 2016 and 2021 were reviewed. E- and L-DGCE were defined using the proposed criteria (5-14 days and > 14 days after surgery, respectively). Specialist nurses followed patients for up 2 years at predefined intervals. About 387 patients were included. The incidence of E-DGCE was 174/387 (45%), and 155/387 (40%) patients presented with L-DGCE at least once during follow-up. The highest prevalence of L-DGCE (19.6%) was identified at postoperative day 28 (POD28) but decreased to 2.9% at the 2-year follow-up. A BMI of ≥30 was a predictor of E-DGCE (P = 0.004) and L-DGCE at POD28 (P = 0.01). No association between E-DGCE and L-DGCE was identified. Using the proposed criteria, the incidence of E-DGCE and prevalence of L-DGCE at POD28 was high. The prevalence of L-DGCE was dynamic but decreased greatly during follow-up. Future prospective studies with multiple follow-ups are needed to validate our findings and the usefulness of the criteria in a clinical setting.
食管癌切除术后胃管道排空延迟（DGCE）是发病率和生活质量下降的主要原因。报道的发病率差异很大（2.2%-47%），部分原因是对DGCE的定义缺乏共识。最近，一个国际专家共识提出了早期DGCE（E-DGCE）和晚期DGCE（L-DGCE）的诊断标准以及症状严重程度评分。使用这些标准，我们在一个大型队列中调查了DGCE的发病率和预测因素。回顾了2016年至2021年在丹麦里格霍斯医院接受食管癌切除加幽门成形术的所有患者。E-DGCE和L-DGCE分别根据提议的标准定义（术后5-14天和>14天）。专科护士按预定间隔对患者进行长达2年的随访。约387例患者被纳入研究。E-DGCE的发病率为174/387（45%），155/387（40%）的患者在随访期间至少出现过一次L-DGCE。L-DGCE的最高患病率（19.6%）在术后第28天（POD28）被确定，但在2年随访时降至2.9%。BMI≥30是E-DGCE（P=0.004）和POD28时L-DGCE（P=0.01）的预测因素。未发现E-DGCE和L-DGCE之间存在关联。使用提议的标准，POD28时E-DGCE的发病率和L-DGCE的患病率较高。L-DGCE的患病率是动态变化的，但在随访期间大幅下降。未来需要进行多次随访的前瞻性研究，以验证我们的发现以及这些标准在临床环境中的实用性。
