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esophageal stricture

Ingrid M Ganske, Joseph M Firriolo, Laura C Nuzzi, Oren Ganor, Thomas E Hamilton, C Jason Smithers, Russell W Jennings, Joseph Upton, Brian I Labow, Amir H Taghinia
BACKGROUND: A variety of surgical techniques exist to manage long-gap esophageal atresia (LGEA), including gastric pull-up (GPU), colonic interposition (CI), jejunal interposition (JI), and distraction lengthening. Salvage reconstruction for late failure of any conduit type is a complex surgical problem fraught with technical difficulty and significant risk. Jejunal interposition can be used as a salvage procedure in the management of LGEA. However, the opposing requirements of conduit length and adequate perfusion make the procedure technically challenging...
June 13, 2018: Annals of Plastic Surgery
V Boyko, S Savvi, A Korolevska, V Zhydetskyy, Y Novikov, S Bytiak, D Shuba
The research is based on the results of the examination and treatment of 156 patients who received treatment for extended benign esophageal strictures after corrosive injuries in the department of diseases of the esophagus and the gastrointestinal tract of the State Institution "V. T. Zaitsev Institute of General and Urgent Surgery of NAMS of Ukraine" for the period from 2000 to 2016. Surgical treatment by the developed in our hospital technique performed in the patients of the main group and the classical methods of surgery were used in the patients of comparison group...
May 2018: Georgian Medical News
Chunhui Zheng, Xiaomei Chen, Fangbiao Zhang, Liping Yan, Xiangyan Zhang
RATIONALE: Primary mucoepidermoid carcinoma (MEC) of the esophagus is a rare type of malignant neoplasm. Its morphology resembles that of MEC of the salivary glands. It is characterized by a diffuse mixture of squamous and mucus-secreting glandular carcinoma cells. Due to the low incidence of esophageal MEC, the biological behavior and treatment of this tumor have not been well studied. PATIENT CONCERNS: In this case report, we describe a case of a 59-year-old man who presented with difficulty in swallowing...
June 2018: Medicine (Baltimore)
Paul Didden, Agnes N Reijm, Nicole S Erler, Leonieke M M Wolters, Thjon J Tang, Pieter C J Ter Borg, Ivonne Leeuwenburgh, Marco J Bruno, Manon C W Spaander
BACKGROUND:  Covered esophageal self-expandable metal stents (SEMSs) are currently used for palliation of malignant dysphagia. The optimal extent of the covering to prevent recurrent obstruction is unknown. Therefore, we aimed to compare fully covered (FC) versus partially covered (PC) SEMSs in patients with incurable malignant esophageal stenosis. METHODS:  In this multicenter randomized controlled trial, 98 incurable patients with dysphagia caused by a malignant stricture of the esophagus or cardia were randomized 1:1 to an FC-SEMS or PC-SEMS...
June 12, 2018: Endoscopy
Kenji Kudo, Kosuke Narumiya, Yohsuke Yagawa, Shinsuke Maeda, Masaho Ota, Harushi Osugi, Masakazu Yamamoto
BACKGROUND: This study investigated the long-term risk factors for pneumonia after esophageal reconstruction using a gastric tube via the posterior mediastinal route following esophagectomy for esophageal cancer. The influence of columnar metaplasia in the remnant esophagus was specifically assessed. METHODS: Among 225 patients who underwent esophagectomy between January 2004 and December 2010, the subjects were 54 patients who could be followed up for more than 5 years...
January 2018: Esophagus: Official Journal of the Japan Esophageal Society
Kexin He, Lili Zhao, Shoushan Bu, Li Liu, Xiang Wang, Min Wang, Zhining Fan
 Esophageal caustic stricture is a stubborn disease and postoperative restenosis limits the clinical efficacy of endoscopic dilation. Autologous mucosal grafts have been successfully applied in the treatment of urethral stricture and in the prevention of stricture after extensive mucosal resection. We aimed to use mucosal autografting performed endoscopically to treat refractory esophageal stricture. METHODS : Three patients with intractable corrosive esophageal stricture were treated endoscopically by combining dilation with autologous mucosal transplantation...
June 11, 2018: Endoscopy
Pernilla Stenström, Martin Salö, Magnus Anderberg, Einar Arnbjörnsson
Background: The aim was to explore if severe congenital heart disease (CHD) influenced the need for dilatation of anastomotic strictures (AS) after the repair of esophageal atresia (EA). Methods: A retrospective case-control study was conducted examining AS in children with EA and Gross type C. The spectra of CHD and cardiac interventions were reviewed. The frequency of dilatations of AS during the first year following EA reconstruction was compared between children with and without severe CHD requiring cardiac surgery during their first year of life...
2018: Gastroenterology Research and Practice
Daisy Walter, Maarten W van den Berg, Meike M Hirdes, Frank P Vleggaar, Alessandro Repici, Pierre H Deprez, Bartolomé L Viedma, Laurence B Lovat, Bas L Weusten, Raf Bisschops, Rehan Haidry, Elisa Ferrara, Keith J Sanborn, Erin E O'Leary, Jeanin E van Hooft, Peter D Siersema
BACKGROUND:  Dilation is the standard of care for recurrent benign esophageal strictures (BES). Biodegradable stents may prolong the effect of dilation and reduce recurrences. Efficacy and safety of dilation and biodegradable stent placement early in the treatment algorithm of recurrent BES were compared. METHODS:  This multicenter, randomized study enrolled patients with BES treated with previous dilations to ≥ 16 mm. The primary end point was number of repeat endoscopic dilations for recurrent stricture within 3 and 6 months...
June 8, 2018: Endoscopy
László Szapáry, Benedek Tinusz, Nelli Farkas, Katalin Márta, Lajos Szakó, Ágnes Meczker, Roland Hágendorn, Judit Bajor, Áron Vincze, Zoltán Gyöngyi, Alexandra Mikó, Dezső Csupor, Péter Hegyi, Bálint Erőss
AIM: To analyze the effect of intralesional steroid injections in addition to endoscopic dilation of benign refractory esophageal strictures. METHODS: A comprehensive search was performed in three databases from inception to 10 April 2017 to identify trials, comparing the efficacy of endoscopic dilation to dilation combined with intralesional steroid injections. Following the data extraction, meta-analytical calculations were performed on measures of outcome by the random-effects method of DerSimonian and Laird...
June 7, 2018: World Journal of Gastroenterology: WJG
Byeong Geun Song, Yang Won Min, Ra Ri Cha, Hyuk Lee, Byung-Hoon Min, Jun Haeng Lee, Poong-Lyul Rhee, Jae J Kim
BACKGROUND: Endoscopic submucosal dissection (ESD) has been widely accepted for treating superficial esophageal squamous cell carcinoma (SESCC). The aim of this study was to evaluate the efficacy and safety of ESD for SESCC and the effect of different sedation methods on their clinical outcomes. METHODS: We retrospectively analyzed a total of 169 patients (175 lesions) who underwent ESD for SESCC at Samsung Medical Center, Seoul, South Korea. Short-term and long-term clinical outcomes were evaluated and compared according to the sedation method (conscious sedation [CS] vs general anesthesia [GA])...
June 7, 2018: BMC Gastroenterology
Andrea Anderloni, Chiara Genco, Marco Massidda, Milena Di Leo, Uberto Romario Fumagalli, Riccardo Rosati, Loredana Correale, Roberta Maselli, Elisa Chiara Ferrara, Manol Jovani, Alessandro Repici
BACKGROUND/AIMS: The study aimed to evaluate the effectiveness and safety of self-expanding metal stents (SEMS) in the management of post-surgical esophageal leaks. METHODS: Retrospective data of consecutive patients with a post-surgical esophageal leak treated by means of a metal stent between January 2008 and December 2014 at the Humanitas Research Hospital (Milan, Italy) were extracted from a prospectively maintained register of SEMS used for benign indications, such as post-surgical benign esophageal strictures and/or leaks...
June 5, 2018: Digestive Surgery
Yasutaka Kuribayashi, Toshiro Iizuka, Kosuke Nomura, Tsukasa Furuhata, Satoshi Yamashita, Akira Matsui, Daisuke Kikuchi, Toshifumi Mitani, Mitsuru Kaise, Shu Hoteya
BACKGROUND/AIMS: Endoscopic submucosal dissection (ESD) for superficial esophageal cancer is sometimes extensive, and in our experience, patients not infrequently present with dysphagia after ESD even in the absence of esophageal stricture. The aim of this study was to evaluate esophageal motility using high-resolution manometry (HRM) in patients with and without dysphagia after extensive circumferential ESD. METHODS: HRM was performed in a total of 52 patients who had undergone ESD for superficial esophageal cancer and a mucosal defect after ESD exceeded more than two-thirds of the esophageal circumference...
June 5, 2018: Digestion
Carolyne Morcos Ghobrial, A E Eskander
BACKGROUND: Esophageal strictures resulting from caustic ingestion in children are usually difficult to be managed, and surgical replacement is usually required for cases refractory to frequent dilatation sessions. Topical Mitomycin C (MMC) has been recently used in the management of resistant strictures. We evaluated the efficacy of MMC application in treatment of long refractory caustic esophageal strictures. METHODS: This prospective study included 120 patients of both sexes with refractory caustic long esophageal strictures (> 3 cm in length)...
June 4, 2018: Surgical Endoscopy
Ryuichiro Sawada, Taro Oshikiri, Tetsu Nakamura, Masashi Yamamoto, Takeru Matsuda, Yasuo Sumi, Tomoo Itoh, Yoh Zen, Satoshi Suzuki, Yoshihiro Kakeji
We report a case of esophageal intramural pseudodiverticulosis associated with an inflammatory esophageal mass with high 18 F-fluorodeoxyglucose (FDG) uptake. A 48-year-old man presented with dysphagia caused by an esophageal stricture. Positron emission tomography/magnetic resonance imaging showed an FDG-avid lesion in the lower esophagus. Due to suspected malignancy, the patient underwent subtotal esophagectomy. Histological examination confirmed the diagnosis of an inflammatory tumor associated with esophageal pseudodiverticulosis...
May 30, 2018: Annals of Thoracic Surgery
Masaya Uesato, Kentarou Murakami, Yoshihiro Nabeya, Kazunori Fugo, Hisahiro Matsubara
Aim: To show our unique strategy of endoscopic submucosal dissection (ESD) for esophageal squamous cell carcinoma larger than the subcircumference. Methods: From April 2011, we used a mucosal preservation method called the log bridge (LB) method for the lesion larger than the subcircumference. The patients in whom the circumference of the mucosal defect was 5/6 to <1 were classified into the LB group; those who underwent whole circumferential ESD were classified into the non-LB group...
2018: Gastroenterology Research and Practice
Robert D Pesek, Sandeep K Gupta
Eosinophilic esophagitis (EoE) is rare but incidence and prevalence is increasing. EoE is characterized by eosinophilic inflammation of the esophagus causing gastrointestinal symptoms such as abdominal pain, vomiting, reflux, dysphagia, and food impactions. If untreated, remodeling and fibrosis of the esophagus can occur and stricture formation may result. Current treatment options are limited to food-restriction diets or medications including proton pump inhibitors (PPIs) or swallowed corticosteroids. Significant progress has been made in understanding the underlying mechanisms of EoE allowing for development of drugs that target specific points in EoE pathways...
May 31, 2018: Expert Opinion on Emerging Drugs
Alfredo J Lucendo, Javier Molina-Infante
PURPOSE OF REVIEW: For patients with eosinophilic esophagitis (EoE), endoscopic dilation has been used primarily to provide immediate symptomatic relief of dysphagia. This report reviews the current position of esophageal dilation in the therapeutic algorithm for EoE, including effectiveness and safety issues. RECENT FINDINGS: Esophageal strictures in EoE develop as a consequence of long-lasting esophageal eosinophilia, with patient age and diagnostic delay as well established risk factors...
July 2018: Current Opinion in Gastroenterology
J Bill, S Rajagopal, V Kushnir, C P Gyawali
Evaluation of dysphagia typically starts with esophagogastroduodenoscopy (EGD); further testing is pursued if this is negative. When no mucosal, structural, or motor esophageal disorders are identified with persisting symptoms, functional dysphagia is considered. We evaluated outcomes in patients undergoing EGD for dysphagia, and estimated prevalence of functional dysphagia. The endoscopy database at single tertiary care center was interrogated to identify EGDs performed for an indication of 'dysphagia' over a 12-month period (2008-09)...
May 24, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
M M Szczesniak, P I Wu, J Maclean, T I Omari, I J Cook
INTRODUCTION: Restrictive defects of the pharyngo-esophageal junction (PEJ) are common in both structural and neurological disorders and are amenable to therapies aiming to reduce outflow resistance. Intrabolus pressure (IBP) acquired with high-resolution manometry and impedance (HRMI) is an indicator of resistance and a marker of reduced PEJ compliance. Constraints and limitations of IBP as well as the optimal IBP parameter remain undefined. AIMS: To determine: (i) the impact of peak pharyngeal pressure (PeakP) on the diagnostic accuracy of IBP for the detection of a restrictive defect at the PEJ and (ii) the optimal IBP parameter for this purpose...
May 24, 2018: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Jan Martínek, Stefan Juhas, Radek Dolezel, Barbora Walterová, Jana Juhasova, Jiri Klima, Zuzana Rabekova, Zuzana Vacková
Endoscopic submucosal dissection or widespread endoscopic resection allow the radical removal of circumferential or near-circumferential neoplastic esophageal lesions. The advantage of these endoscopic methods is mini-invasivity and low risk of major adverse events compared to traditional esophagectomy. The major drawback of these extensive resections is the development of stricture - the risk is 70-80% if more than 75% of the circumference is removed and almost 100% if the whole circumference is removed. Thus, an effective method to prevent post-ER/ESD esophageal stricture would be of major benefit, because treatment of strictures requires multiple sessions of endoscopic dilatation and may carry a risk of perforation...
May 24, 2018: Minerva Chirurgica
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