Pyloroplasty During Esophagectomy

Not currently recruiting at 1 trial location
JW
Overseen ByJulie Ward, BSN
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Approved in 4 JurisdictionsThis treatment is already approved in other countries

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine whether adding a pyloroplasty, a procedure that aids stomach drainage, during an esophagectomy (surgery to remove part of the esophagus) affects outcomes compared to not adding it. The study divides participants into two groups: one group will undergo esophagectomy with pyloroplasty, and the other without it. Individuals requiring an esophagectomy for either non-cancerous or cancerous conditions, with their stomach used as a conduit, might be suitable candidates. As an unphased trial, this study provides a unique opportunity to contribute to medical knowledge and potentially enhance surgical outcomes for future patients.

Do I have to stop taking my current medications for the trial?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that pyloroplasty, performed during surgery to remove part of the esophagus, is generally safe. Studies have found that it helps avoid additional procedures to manage the stomach's opening, indicating good patient tolerance.

Pyloroplasty is also used for other stomach issues, such as gastroparesis, where the stomach empties slowly. It boasts a high success rate of nearly 90% for these conditions. However, some research questions its necessity during esophagus surgery, as it might not improve stomach emptying and could cause other issues.

Overall, pyloroplasty's safety appears strong, but its necessity during esophagus surgery remains debated.12345

Why are researchers excited about this trial?

Researchers are excited about the use of pyloroplasty during esophagectomy because it offers a potential improvement over the traditional approach of esophagectomy without pyloroplasty. While standard esophagectomy aims to remove cancerous tissue in the esophagus, adding pyloroplasty helps by surgically widening the pylorus, the opening between the stomach and small intestine. This can enhance gastric emptying and reduce postoperative complications like delayed gastric emptying. By improving the digestive process, pyloroplasty during esophagectomy could lead to better recovery outcomes and quality of life for patients.

What evidence suggests that pyloroplasty during esophagectomy could be effective?

This trial will compare esophagectomy with pyloroplasty to esophagectomy without it. Research has shown that pyloroplasty, a procedure that aids in stomach emptying, can be beneficial during esophagectomy, which involves removing part of the esophagus. Studies have found that pyloroplasty reduces the need for additional procedures to open the stomach valve post-surgery. Patients without pyloroplasty might lose more weight due to these additional procedures. The procedure is generally considered safe and can aid recovery. However, some research suggests disagreement on its necessity during surgery.12456

Who Is on the Research Team?

JL

James Luketich, MD

Principal Investigator

University of Pittsburgh

Are You a Good Fit for This Trial?

This trial is for adults aged 18-85 who need an esophagectomy, a surgery to remove part of the esophagus, due to benign or malignant conditions. They must have an ECOG performance status of 0-2 and be able to use their stomach as a conduit post-surgery. It's not for those over 85 or under 18, with BMI >50, prior pylorus operations, previous gastric bypass or resection, liver issues, or if they can't tolerate surgery.

Inclusion Criteria

I am willing to have surgery to remove part of my esophagus.
My surgery involved using my stomach to connect other organs.
I am able to care for myself and perform daily activities.

Exclusion Criteria

I have had surgery on the part of my stomach that connects to my small intestine.
I cannot undergo surgery due to my health condition.
My doctor has diagnosed me with liver cirrhosis or liver failure.
See 4 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Surgery

Participants undergo esophagectomy with or without pyloroplasty

1 day
1 visit (in-person)

Postoperative Monitoring

Participants are monitored for complications such as pneumonia and esophageal anastomosis leak

30 days

Follow-up

Participants are monitored for long-term outcomes including quality of life and complications

24 months

What Are the Treatments Tested in This Trial?

Interventions

  • Esophagectomy
  • Pyloroplasty
Trial Overview The study is testing whether adding a procedure called pyloroplasty (to help empty the stomach) during an esophagectomy offers benefits compared to just having the esophagectomy without this additional procedure. Participants are randomly assigned to either receive pyloroplasty or not during their surgery.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Active Control
Group I: Esophagectomy without PyloroplastyExperimental Treatment1 Intervention
Group II: Esophagectomy with PyloroplastyActive Control2 Interventions

Esophagectomy is already approved in European Union, United States, Japan, China for the following indications:

🇪🇺
Approved in European Union as Esophagectomy for:
🇺🇸
Approved in United States as Esophagectomy for:
🇯🇵
Approved in Japan as Esophagectomy for:
🇨🇳
Approved in China as Esophagectomy for:

Find a Clinic Near You

Who Is Running the Clinical Trial?

University of Pittsburgh

Lead Sponsor

Trials
1,820
Recruited
16,360,000+

Citations

Effect of pyloroplasty on clinical outcomes following ...Overall results from our study that pyloroplasty during Ivor Lewis esophagectomy is safe and useful to prevent the need for post-operative pyloric dilatation.
Intraoperative pyloric drainage is unnecessary during ...Pyloroplasty following esophagectomy in elective esophageal surgery is still recommended as a routine procedure by many authors, but ...
3.pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov/39363104
Effect of pyloroplasty on clinical outcomes following ...Overall results from our study that pyloroplasty during Ivor Lewis esophagectomy is safe and useful to prevent the need for post-operative pyloric dilatation.
(PDF) Effect of pyloroplasty on clinical outcomes following ...Subgroup analysis of patients without pyloroplasty indicated that patients requiring dilatation had greater weight loss at 1 year (15.8% vs 9.4% ...
Functional disorders and quality of life after ...Endoscopic dilatation is effective in 70 to 97% of patients [24], [31], [32] even after previous pyloroplasty [31]. There is no agreement on the delay beyond ...
Pyloroplasty: Surgery Definition, Procedure & RisksAs a solution for gastroparesis and gastric outlet obstruction, pyloroplasty surgery has excellent results, with reported success rates of close to 90%. When ...
Unbiased ResultsWe believe in providing patients with all the options.
Your Data Stays Your DataWe only share your information with the clinical trials you're trying to access.
Verified Trials OnlyAll of our trials are run by licensed doctors, researchers, and healthcare companies.
Terms of Service·Privacy Policy·Cookies·Security