Troubles fonctionnels et qualité de vie après œsophagectomie et gastroplastie pour cancer

Functional disorders such as delayed gastric emptying, dumping syndrome or duodeno-gastro-esophageal reflux occur in half of the patients who underwent esophagectomy and gastric tube reconstruction for cancer. The potential role of pyloroplasty to prevent development of functional disorders is still debated. The use of antireflux fundoplication procedures during esophagectomy seems able to decrease reflux but increases the complexity of the operation and remain scarcely used. The treatment of these functional disorders arising after esophagectomy and gastroplasty for cancer mainly relies on dietary modifications. The efficiency of proton pump inhibitors is well documented and they should be given routinely to prevent reflux complications. Erythromycin may prevent delayed gastric emptying, but it should be used with caution in patients with cardiovascular disorders. In case of anastomotic stricture, endoscopic dilatation is usually efficient. Gastrointestinal function related problems after oesophageal resection and gastric tube reconstruction do not impair significantly quality of life at long term, which is mainly influenced by the tumor recurrence status.