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esophageal stricture

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https://www.readbyqxmd.com/read/29044576/long-term-outcomes-after-hand-sewn-versus-circular-stapled-25-and-29%C3%A2-mm-anastomotic-technique-after-esophagogastrectomy-for-esophageal-cancer
#1
Jack W Rostas, Beunca D Graffree, Charles R Scoggins, Kelly M McMasters, Robert C G Martin
BACKGROUND: Anastomotic stricture following esophagogastrectomy (EG) can lead to significant dysphagia, necessitating interventions such as endoscopic dilatation. These post-operative complications gain importance with the increased survival rate of patients after EG. This study aimed to assess the outcomes of both circular-stapled (CS: 25 and 29 mm) and hand-sewn (HS) anastomoses after EG. METHODS: We reviewed prospectively accrued data from December 2004 to December 2014 identifying all patients undergoing EG for esophageal cancer...
October 16, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29040484/esophagocardioplasty-vagotomy-antrectomy-and-roux-en-y-gastrojejunostomy-indication-in-cases-with-severe-esophageal-motor-disfunction
#2
I Braghetto, O Korn, A Csendes, J C Frias
Almost 10% of patients with Crest syndrome associated with severe gastroesophageal reflux and 5-10% of patients with failed cardiomyotomy for achalasia present with cardial or distal esophageal organic stricture. Some of these cases are poor risk patients for surgery and therefore the surgeon must offer a safe procedure with low morbimortality, keeping in mind the pathophysiological motor pattern of these patients.In order to treat the stricture to improve the esophageal transit we treated patients with esophagocardioplasty associated with vagotomy-antrectomy and Roux-en-Y gastrojejunostomy, thereby avoiding the potential acid or biliary reflux in poor risk patients in whom esophagectomy would be a very deleterious procedure...
November 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29038643/current-diagnostic-and-treatment-strategies-for-eosinophilic-esophagitis
#3
Anna M Lipowska, Robert T Kavitt
Eosinophilic esophagitis (EoE) is a chronic inflammatory disorder of the esophagus diagnosed by the presence of esophageal symptoms accompanied by an esophageal eosinophilic infiltrate. EoE has an increasing worldwide prevalence and can be a cause of dysphagia and food impactions. There is an important role for the use of proton pump inhibitors in the diagnostic pathway of EoE. Treatment paradigms for EoE aim to minimize esophageal inflammation and improve symptom control. Dietary therapy targets dietary allergens and encompasses the elemental diet, the allergy testing-directed elimination diet, and the empiric elimination diet...
September 2017: Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29034088/emerging-dilemmas-in-the-diagnosis-and-management-of-gastroesophageal-reflux-disease
#4
REVIEW
Peter Kahrilas, Rena Yadlapati, Sabine Roman
Gastroesophageal reflux disease (GERD) is common, but less so than widely reported because of inconsistencies in definition. In clinical practice, the diagnosis is usually based on a symptom assessment without testing, and the extent of diagnostic testing pursued should be limited to that which guides management or which protects the patient from the risks of a potentially morbid treatment or an undetected early (or imminent) esophageal adenocarcinoma or which does both. When testing is pursued, upper gastrointestinal endoscopy is the most useful initial diagnostic test because it evaluates for the major potential morbidities (Barrett's, stricture, and cancer) associated with GERD and facilitates the identification of some alternative diagnostic possibilities such as eosinophilic esophagitis...
2017: F1000Research
https://www.readbyqxmd.com/read/29033756/progression-from-an-inflammatory-to-a-fibrostenotic-phenotype-in-eosinophilic-esophagitis
#5
Nathaniel T Koutlas, Evan S Dellon
Previous studies have suggested that eosinophilic esophagitis (EoE) progresses from chronic inflammation to fibrostenosis. However, natural history data illustrating this progression in individual patients are lacking. Here, we present 6 patients who progressed from an inflammatory to a fibrostenotic phenotype of EoE in the absence of treatment. At the time of diagnosis, none of the patients had significant evidence of fibrostenosis, but they did have other inflammatory findings of EoE such as edema, linear furrows, or exudates...
May 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29031028/risk-factors-for-death-in-dogs-treated-for-esophageal-foreign-body-obstruction-a-retrospective-cohort-study-of-222-cases-1998-2017
#6
A G Burton, C T Talbot, M S Kent
BACKGROUND: Limited data exist describing risk factors for death, and long-term outcomes in dogs with esophageal foreign body (EFB) obstruction. HYPOTHESIS/OBJECTIVES: To evaluate short- and long-term outcomes, and analyze risk factors for death in dogs with EFB obstruction. We hypothesized duration of entrapment and treatment type would affect outcome. ANIMALS: A total of 222 dogs were treated for EFB obstruction at an emergency and referral hospital between March 1998 and March 2017...
October 14, 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/29021479/a-japanese-case-of-esophageal-lichen-planus-that-was-successfully-treated-with-systemic-corticosteroids
#7
Yuki Sato, Ryuta Takenaka, Akihiro Matsumi, Kensuke Takei, Shotaro Okanoue, Eriko Yasutomi, Daisuke Kawai, Koji Takemoto, Hirofumi Tsugeno, Takayoshi Miyake, Shigeatsu Fujiki
Esophageal lichen planus (ELP) is rare and only about 80 cases have been reported in the literature. An 85-year-old woman presented with dysphagia and odynophagia. Endoscopy revealed a severe stricture in the proximal esophagus. Oral examinations at two years after the first endoscopy revealed erosions around the gingiva, and an examination of biopsy specimens taken from the site of erosion led to a diagnosis of oral LP. Esophageal endoscopy was performed again, and biopsy specimens showed spongiosis and necrotic keratinocytes in the epithelium (civatte bodies)...
October 11, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29021429/sclerosing-esophagitis-with-igg4-positive-plasma-cell-infiltration-a-case-report
#8
Shigeo Mori, Yoshiya Tahashi, Kazushige Uchida, Tsukasa Ikeura, Naoyuki Danbara, Takahiro Wakamatsu, Takeo Kusuda, Yu Takahashi, Masato Yanagawa, Mitsunobu Matsushita, Chisato Ohe, Taku Michiura, Kentaro Inoue, Masanori Kon, Kazuichi Okazaki
The patient was a 76-year-old woman who had noticed slight difficulty in swallowing in the 3 years prior to this presentation. Her dysphagia progressed while she was hospitalized following cervical cancer surgery. Esophagogastroduodenoscopy and an esophagram showed circumferential erosion and a stricture of the thoracic esophagus. Esophageal resection was performed; the resected specimens showed a stricture and wall thickening. Histologically, transmural hyperplasia, which consisted of inflammatory granulation tissue with the abundant infiltration of IgG4-positive plasma cells and lymphocytes, was observed...
October 11, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29019570/thoraco-laparoscopic-esophagectomy-thoracic-stage-in-prone-position
#9
Carlos Bernardo Cola, Flávio Duarte Sabino, Carlos Eduardo Pinto, Maria Ribeiro Morard, Pedro Portari, Tereza Guedes
OBJECTIVE: to analyze the National Cancer Institute Abdominopelvic Division (INCA / MS/HC I) initial experience with thoraco-laparoscopic esophagectomy with thoracic stage in prone position. METHODS: we studied 19 consecutive thoraco-laparoscopic esophagectomies from may 2012 to august 2014, including ten patients with squamous cells carcinoma (five of the middle third and five of the lower third) and nine cases of gastroesophageal junction adenocarcinoma (six Siewert I and three Siewert II)...
September 2017: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/29018965/the-role-of-maintenance-therapy-in-eosinophilic-esophagitis-who-why-and-how
#10
REVIEW
Hamish Philpott, Evan S Dellon
In patients with eosinophilic esophagitis (EoE) who do not respond to proton pump inhibitors, initial anti-inflammatory/anti-eosinophilic treatment is with either topical corticosteroids or dietary elimination. A large body of literature supports the efficacy of these approaches, with histologic response rates in the 50-90% range for steroids and 70% range for the six-food elimination diet. However, these studies are almost all short-term and data evaluating long-term safety and efficacy of either treatment are limited...
October 10, 2017: Journal of Gastroenterology
https://www.readbyqxmd.com/read/28993137/endoscopic-submucosal-dissection-for-early-barrett-s-neoplasia-a-meta-analysis
#11
REVIEW
Dennis Yang, Fei Zou, Sican Xiong, Justin J Forde, Yu Wang, Peter V Draganov
BACKGROUND AND AIMS: The role of endoscopic submucosal dissection (ESD) in Barrett's esophagus (BE) is not well established. This meta-analysis aimed to evaluate the safety and efficacy of ESD for the management of early BE neoplasia. METHODS: Three online databases were searched. The Cochran Q test and I(2) were used to test for heterogeneity. Pooling was conducted using either fixed- or random-effects models depending on heterogeneity across studies. For the main outcomes, potential sources of heterogeneity were evaluated via linear regression analysis...
October 6, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28980899/oesophageal-disease-in-systemic-sclerosis-does-heritability-play-a-role
#12
Tracy Frech, Latifa Fakoya, Andrew J Gawron, Jathine Wong, Mary Beth Scholand, Allen Sawitzke, Kathryn Peterson
OBJECTIVES: In systemic sclerosis (SSc) the most common gastrointestinal tract (GIT) complaint is gastroesophageal reflux disease (GERD), which may contribute to oesophagitis, stricture, Barrett's oesophagus, and oesophageal adenocarcinoma. We used a genealogical resource the Utah Population Database (UPDB) to analyse SSc pedigrees for hereditability of oesophageal disease. METHODS: SSc, GERD, oesophagitis, stricture, Barrett's, and oesophageal adenocarcinoma were defined by ICD Ninth and Tenth Revision codes...
October 2, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28980205/double-step-invagination-technique-a-novel-approach-to-retrieve-embedded-esophageal-self-expanding-metal-stent
#13
T S Chandrasekar, Raja Yogesh Kalamegam, Gokul Bollu Janakan, Sathiamoorthy Suriyanarayanan, Prasad Sanjeevaraya Menta, Viveksandeep Thoguluva Chandrasekar
Self-expanding metal stenting is an established treatment modality in the management of esophageal growth and stricture. Reactive tissue ingrowth at the uncovered portion of the self-expanding metal stent (SEMS) anchors it in position, preventing its migration. When removal of such an embedded SEMS is clinically indicated, the procedure of endoscopic retrieval is fraught with serious complications. Temporary deployment of a larger fully covered "rescue" SEMS within the embedded SEMS has been reported to be useful in the extraction of the embedded SEMS...
October 5, 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/28979715/successful-endoscopic-removal-of-three-embedded-esophageal-self-expanding-metal-stents
#14
Xiao-Qin Liu, Min Zhou, Wen-Xin Shi, Yi-Ying Qi, Hui Liu, Bin Li, Hong-Wei Xu
In the report, we describe a case of refractory benign esophageal strictures from esophageal cancer after an operation for the placement of three partially covered self-expanding metal stents (SEMSs), which were all embedded in the esophageal wall. Using the stent-in-stent technique, the three embedded SEMSs were successfully removed without significant complications. To the best of our knowledge, few cases of the successful removal of multiple embedded esophageal SEMSs have been reported in the literature...
September 16, 2017: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28970723/high-yield-reproducible-rat-model-recapitulating-human-barrett-s-carcinogenesis
#15
Daisuke Matsui, Ashten N Omstead, Juliann E Kosovec, Yoshihiro Komatsu, Emily J Lloyd, Hailey Raphael, Ronan J Kelly, Ali H Zaidi, Blair A Jobe
AIM: To efficiently replicate the biology and pathogenesis of human esophageal adenocarcinoma (EAC) using the modified Levrat model of end-to-side esophagojejunostomy. METHODS: End-to-side esophagojejunostomy was performed on rats to induce gastroduodenoesophageal reflux to develop EAC. Animals were randomly selected and serially euthanized at 10 (n = 6), 17 (n = 8), 24 (n = 9), 31 (n = 6), 38 (n = 6), and 40 (n = 6) wk postoperatively. The esophagi were harvested for downstream histopathology and gene expression...
September 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28942656/use-of-self-expanding-nitinol-stents-in-the-pediatric-management-of-refractory-esophageal-caustic-stenosis
#16
Verónica Alonso, Devicka Ojha, Harsha Nalluri, Juan Carlos de Agustín
BACKGROUND: The treatment of recurrent esophageal stricture secondary to the ingestion of a caustic agent is an arduous task. Self-expanding esophageal stents may be an alternative to repeated endoscopic esophageal dilations. CASE REPORT: We present the case of a two-year-old male with a severe and long esophageal stricture successfully treated by the combination of dilations and stent placement. After five months of serial pneumatic dilations, three self-expanding nitinol stents internally coated with silicone were introduced through a gastrostomy, covering the entire esophagus...
October 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28914345/comparison-of-clinical-outcomes-between-open-and-thoracoscopic-repair-for-esophageal-atresia-with-tracheoesophageal-fistula-a-systematic-review-and-meta-analysis
#17
Yuhao Wu, Hongyu Kuang, Tiewei Lv, Chun Wu
OBJECTIVE: A meta-analysis was performed for a comparison of outcomes between open repair (OR) and thoracoscopic repair (TR) for esophageal atresia with tracheoesophageal fistula (EA with TEF). METHODS: Electronic databases, including PubMed, Cochrane Library, and Medline, were searched systematically for the literatures aimed mainly at comparing the therapeutic effects for EA with TEF administrated by OR and TR. Corresponding data sets were extracted and two reviewers independently assessed the methodological quality...
September 15, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28913339/ulcerative-gastritis-and-esophagitis-in-two-children-with-sarcina-ventriculi-infection
#18
Tim G J de Meij, Michiel P van Wijk, Aart Mookhoek, Andries E Budding
Sarcina ventriculi is a Gram-positive, obligate anaerobic coccus, with a characteristic morphology. Only 22 cases of human infections by this microorganism, including 7 in children, have been reported in literature so far. Affected subjects usually present with abdominal pain, nausea, vomiting, and delayed gastric emptying. However, life-threatening complications, like emphysematous gastritis and gastric perforation have also been described. Gastroparesis and gastric outlet obstruction have been considered as a potential etiologic factor...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28905803/diagnosis-and-treatment-of-gastroesophageal-reflux-disease-complicated-by-barrett-s-esophagus
#19
Andriy Stasyshyn
The aim of the study was to evaluate the effectiveness of a diagnostic and therapeutic algorithm for gastroesophageal reflux disease complicated by Barrett's esophagus in 46 patients. MATERIALS AND METHODS: A diagnostic and therapeutic algorithm for complicated GERD was developed. To describe the changes in the esophagus with reflux esophagitis, the Los Angeles classification was used. Intestinal metaplasia of the epithelium in the lower third of the esophagus was assessed using videoendoscopy, chromoscopy, and biopsy...
August 31, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28902039/topical-mitomycin-c-application-is-effective-even-in-esophageal-strictures-resistant-to-dilatation-therapy-in-children
#20
Emre Divarci, Ozge Kilic, Zafer Dokumcu, Coskun Ozcan, Ata Erdener
PURPOSE: Several treatment techniques may be used in the treatment of esophageal strictures. The purpose of this study was to present the effects of topical mitomycin C (TMC) as an useful adjunct to dilatation therapy in esophageal strictures. MATERIALS AND METHODS: A retrospective analysis of patients who underwent TMC between February 2015 and July 2016 was performed. Dysphagia score, periodic dilatation index, and number of dilatations were compared before and after intervention to investigate the efficacy of TMC...
September 8, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
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