Intraoperative endoscopic pylorus dilatation during minimally invasive

introductionOesophageal cancer has a poor prognosis and oesophagectomy has increasingly adopted minimally invasive techniques, but delayed gastric conduit emptying (DGCE) still occurs in ~10-50% of patients, depending on the used diagnostic criteria and definitions. DGCE can cause serious complications, such as aspiration pneumonia, and it prolongs hospital stay and the overall morbidity of patients. Surgical pyloric drainage procedures (pyloroplasty or pyloromyotomy) have not clearly improved outcomes. Endoscopic pyloric balloon dilatation (EPBD) effectively treats established DGCE, and emerging evidence suggests that prophylactic EPBD may reduce its incidence. However, no randomised trial has evaluated intraoperative EPBD during minimally invasive oesophagectomy until now. The WIDE trial will test whether adding an EPBD during oesophagectomy can prevent early postoperative DGCE. METHODS AND ANALYSIS: WIDE is a single-centre, double-blind randomised controlled trial, in which 116 adult patients undergoing minimally invasive ETHICS AND DISSEMINATION: The protocol (V.1.3) has been approved by the Northwestern and Central Switzerland Ethics Committee (EKNZ; BASEC 2025-01877). Written informed consent will be obtained from all participants. The trial is classified as a Category A (minimal-risk) study under the Swiss Human Research Act and Clinical Trials Ordinance (ClinO). Findings will be disseminated in peer-reviewed journals and conference presentations, as well as in our in-hospital journal in a lay version for patients. TRIAL REGISTRATION NUMBER: NCT07355374.