• Medicine · Sep 2023

    Randomized Controlled Trial

    Prevention of delayed gastric emptying after right colectomy with extended lymphadenectomy: A randomized controlled trial.

    • Răzvan Cătălin Popescu, Nicoleta Leopa, Ionut-Eduard Iordache, Cristina Dan, Cosmin Moldovan, Andrei-Cristian Ghioldis, Cornelia Minodora Olteanu, Andrea Kacani, Iulia Cindea, and Ioana Popescu.
    • Department of General Surgery, Emergency Hospital of Constanța, Constanța, Romania.
    • Medicine (Baltimore). 2023 Sep 22; 102 (38): e35255e35255.

    BackgroundDelayed gastric emptying sometimes occurs after right colectomy with extended lymphadenectomy. The aim of this randomized controlled trial is to evaluate the effect on delayed gastric emptying after performing a fixation of the stomach to the retrogastric tissue to return the stomach to a physiological position after right colectomy with lymphadenectomy, including gastrocolic lymph nodes dissection for proximal transverse colon cancer.MethodsFrom January 2015 to December 2020, patients undergoing right colectomy with extensive lymphadenectomy for proximal transverse colon cancer were randomly assigned to either the gastropexy group or the conventional group. In the gastropexy group, the posterior wall of the stomach, at the level of the antrum, was sutured to the retrogastric tissue to prevent the abnormal shape that the gastric antrum acquires together with the duodeno-pancreatic complex, the shape that leads to an obstruction of the antrum region and to the delay in emptying the gastric contents.ResultsMean age, sex, comorbidities, and right colectomy procedures were similar in the 2 groups. Delayed gastric emptying developed in twelve patients in the conventional group (38.7%) versus 4 patients (12.1%) in the gastropexy group (P = .014). The total number of complications was higher in the conventional group (14 complications) than in the gastropexy group (7 complications). According to univariate analysis, gastropexy significantly lowered the risk of delayed gastric emptying (P = .014). Overall morbidity was 9.7% in the conventional group versus none in the gastropexy group. Postoperative hospitalization was longer in the conventional group (7.61 ± 3.26 days) than in the gastropexy group (6.24 ± 1.3 days; P = .006).ConclusionGastropexy decreases the occurrence of delayed gastric emptying after right colectomy with extended lymphadenectomy for proximal transverse colon cancer.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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