Poster Presentation AANZGOSA-SUGSS ASM 2024

Gastroparesis without symptoms the case for routine endoscopic surveillance after minimally invasive oesophagectomy (#21)

Matija Mandic 1 , Debbie Chai 1 , Sanj Kariyawasam 1
  1. Fiona Stanley Hospital, Spearwood, WESTERN AUSTRALIA, Australia

Purpose:
This study aimed to investigate the incidence and risk factors associated with gastroparesis following minimally invasive oesophagectomy (MIO) in oesophageal cancer patients. Gastroparesis, a common postoperative complication, can lead to significant morbidity, including silent aspiration if undiagnosed. Early identification is crucial for improving postoperative care and outcomes.

Methods:
A retrospective review was conducted on patients who underwent elective MIO between 2017 and 2021 at a single center. Gastroparesis was diagnosed by detecting food debris in the conduit during routine endoscopy one year post-MIO, despite adequate fasting. Analyses focused on determining the incidence of gastroparesis, the proportion of asymptomatic cases, and identifying potential risk factors.

Results:
Out of 126 patients, 27.8% developed gastroparesis, with 40% being asymptomatic before endoscopic diagnosis. Twelve patients (34.3%) required endoscopic intervention. No statistically significant predictors of gastroparesis were identified, despite analyzing factors such as age, gender, BMI, smoking status, preoperative weight loss, comorbidities, tumor stage, grade, anastomotic location, and anastomotic leak.

Conclusions:
Gastroparesis affects 27.8% of patients post-MIO, with 40% being asymptomatic. Routine endoscopic screening is essential for early detection and management, reducing complications like silent aspiration. Further research is needed to identify potential risk factors and preventive strategies.