312. THE VALUE OF DETECTING THE GASTRIC TUBE PRESSURE AFTER MINIMALLY INVASIVE ESOPHAGECTOMY: A PROSPECTIVE, UNCONTROLLED EXPLORATORY STUDY

Abstract Background With the increasing popularity of minimally invasive esophagectomy(MIE), the incidence of postoperative gastric conduit dilation has also shown an increasing trend. The main purpose of this study is to explore the relationship between postoperative tubular gastric dilation and internal gastric tube pressure. Methods In a prospective cohort study from November 2023 to February 2024, 54 patients undergoing MIE were enrolled. Based on postoperative chest X-ray, patients were categorized into acute gastric conduit dilation (Acd) and non-acute dilation (Non-Acd) groups. Gastric tube pressure, including static pressures(SP), peak pressures(PP), and median pressures (MP), was measured postoperatively. Acute gastric dilation was defined as the gastric tube occupying over 40% of the hemithorax on X-ray. We compared the incidence of postoperative complications, surgery-related mortality, readmission rates, and hospital stay durations. Results Of the patients, 19 experienced acute gastric dilation, while 35 did not. The Acd group showed significantly higher SP, PP, and MP (p<0.01). Univariate analysis identified SP, PP, MP, and upper mediastinal pleura reconstruction as risk factors for acute gastric dilation, with SP being a key predictor in multivariate analysis. Patients in the Acd group had longer hospital stays (median 13 days vs. 8 days for Non-Acd). No significant differences were noted in postoperative complications, surgery-related mortality or readmission rates. Conclusion Acute gastric conduit dilation post-MIE is linked to increased gastric tube pressure. Monitoring this pressure is both safe and feasible, offering insights into reducing acute gastric dilation through surgical improvements such as mediastinal pleura reconstruction.