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Purpose <p>Delayed gastric conduit emptying (DGCE) is a functional complication after esophagectomy that can cause nutritional and respiratory issues, but its risk factors remain unclear.</p> Methods <p>We retrospectively analyzed 166 patients after esophagectomy at Gifu University Hospital (2020–2024). DGCE was diagnosed per International Society for Diseases of the Esophagus criteria and graded using a novel radiographic classification (Grade 1–3). Clinical and postoperative outcomes were compared, and risk factors analyzed by logistic regression.</p> Results <p>DGCE occurred in 29 patients (17.5%). Early DGCE patients were more often female (<i>p</i> = 0.005), had greater gastric conduit–mediastinum length difference (<i>p</i> &lt; 0.001), and fewer fixation sutures (<i>p</i> &lt; 0.001). No independent predictors were identified, though female sex and higher body mass index (BMI) showed trends. Pneumonia and late DGCE were more frequent (both <i>p</i> &lt; 0.001). Severe DGCE (Grade 3) caused greater weight loss at 6 months and 1 year (<i>p</i> = 0.013, <i>p</i> &lt; 0.001).</p> Conclusions <p>Post-esophagectomy DGCE was linked to excessive conduit length and insufficient fixation. Careful intraoperative handling and structured long-term follow-up are crucial.</p>

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Clinical significance and predictive factors of delayed gastric conduit emptying after esophagectomy

  • 期刊论文

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  • 发表日期：

    2026年7月2日

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  • Yuta Sato,
  • Yoshihiro Tanaka,
  • Yuji Hatanaka,
  • Seito Fujibayashi,
  • Noriki Mitsui,
  • Ryoma Yokoi,
  • Takeshi Horaguchi,
  • Keita Matsumoto,
  • Masahiro Fukada,
  • Itaru Yasufuku,
  • Ryuichi Asai,
  • Jesse Yu Tajima,
  • Nobuhisa Matsuhashi

摘要

Purpose

Delayed gastric conduit emptying (DGCE) is a functional complication after esophagectomy that can cause nutritional and respiratory issues, but its risk factors remain unclear.

Methods

We retrospectively analyzed 166 patients after esophagectomy at Gifu University Hospital (2020–2024). DGCE was diagnosed per International Society for Diseases of the Esophagus criteria and graded using a novel radiographic classification (Grade 1–3). Clinical and postoperative outcomes were compared, and risk factors analyzed by logistic regression.

Results

DGCE occurred in 29 patients (17.5%). Early DGCE patients were more often female (p = 0.005), had greater gastric conduit–mediastinum length difference (p < 0.001), and fewer fixation sutures (p < 0.001). No independent predictors were identified, though female sex and higher body mass index (BMI) showed trends. Pneumonia and late DGCE were more frequent (both p < 0.001). Severe DGCE (Grade 3) caused greater weight loss at 6 months and 1 year (p = 0.013, p < 0.001).

Conclusions

Post-esophagectomy DGCE was linked to excessive conduit length and insufficient fixation. Careful intraoperative handling and structured long-term follow-up are crucial.