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Esophageal resection

Seung-Hun Chon, Felix Berlth, De-Hua Chang, Stefan P Mönig
Bleeding of an aberrant right subclavian artery following transthoracic en bloc esophagectomy and intrathoracic gastric reconstruction is a rare but severe complication in esophageal surgery. Preoperative diagnosis can be achieved by computed tomography or magnetic resonance angiography (MRA). Various treatment options are available; thus, the treatment can be challenging and should be adjusted to the severity of the symptoms. Bleeding of an aberrant right subclavian artery can result from perioperative vascular injury or various postoperative complications...
February 2018: Radiology Case Reports
V Arantes, J Espinoza-Ríos
The incidence of esophageal cancer is steadily increasing worldwide. Outcome is poor, given that the majority of cases are diagnosed at advanced disease stages. However, when detected at early stages, esophageal tumors can be curatively treated through less invasive methods, resulting in a 5-year survival rate above 90%. Therefore, it is essential to identify the high-risk population and recommend those patients undergo screening using high-resolution endoscopy, adding the resources of chromoendoscopy with Lugol solution (or digital chromoendoscopy) and magnification...
March 15, 2018: Revista de Gastroenterología de México
Joonas H Kauppila, Karl Wahlin, Pernilla Lagergren, Jesper Lagergren
PURPOSE: Centralization of surgery improves the survival following esophagectomy for cancer, but whether university hospital setting or surgeon volume influences the reoperation rates is unknown. We aimed to clarify whether hospital status or surgeon volume are associated with a risk of reoperation after esophagectomy. METHODS: Patients who underwent esophagectomy for esophageal cancer in 1987-2010 were identified from a population-based, nationwide Swedish cohort study...
March 2, 2018: European Journal of Surgical Oncology
Tsz Yeung Kam, Melpomeni Kountouri, Arnaud Roth, Frossard Jean-Loui, Olivier Huber, Stefan Mönig, Thomas Zilli
Radical esophagectomy with extended lymph node dissection is considered the standard of care in treatment of squamous cell carcinoma of esophagus with deep mucosal invasion (pT1a m3) or submucosal involvement (pT1b). However, despite the increasing use of minimally invasive approaches, it remains a major surgery associated with significant morbidities and even mortality risk. Endoscopic resection (ER) results in excellent local control in early superficial mucosal (pT1a) disease yet there is substantial risk of lymph node metastases in T1b disease...
April 2018: Critical Reviews in Oncology/hematology
Alexander D Jobrack, Suman Goel, Alvin M Cotlar
Introduction: Granular cell tumors (GCTs) are of neuroectodermal origin and account for 0.5% of soft tissue tumors. They are most prevalent in African-Americans in the fourth to sixth decades, with a predilection for the head and neck regions. GCTs usually resemble more common lesions and hence are difficult to diagnose preoperatively. The tumor is readily identified on needle biopsy. Although usually benign with a malignancy rate of only 2-3%, the malignant form has a reported 3-yr mortality of 60%...
March 14, 2018: Military Medicine
Geny Piro, Carmine Carbone, Raffaela Santoro, Giampaolo Tortora, Davide Melisi
Introduction Esophageal and esophago-gastric junction (EGJ) adenocarcinomas remain a major health problem worldwide with a worryingly increasing incidence. Recent trials indicate survivals benefit for preoperative or perioperative chemoradiotherapy compared to surgery alone. Beside standard chemoradiotherapy regimens, new therapeutic approaches with targeted therapies have been proposed for the treatment of resectable disease. However, clinical outcomes remain extremely poor due to drug resistance phenomena...
March 16, 2018: Expert Review of Molecular Diagnostics
Dimitrios Schizas, Ioannis I Lazaridis, Demetrios Moris, Aikaterini Mastoraki, Lazaros-Dimitrios Lazaridis, Diamantis I Tsilimigras, Nikolaos Charalampakis, Theodore Liakakos
BACKGROUND: Despite the improvements in the early detection and treatment of non-metastatic esophageal cancer, more than half of patients undergoing a curative treatment for esophageal cancer will develop recurrence within three years. The prognosis of these patients is poor. However, a wide range in overall survival has been reported, depending on the pattern of recurrence, and no optimal treatment strategy following recurrence has yet been uniformly accepted. AIM: In this article, we aimed to systematically review the literature for the role of surgical resection of metachronous distant metastasis following primary treatment of esophageal cancer...
March 14, 2018: World Journal of Surgical Oncology
Tomoki Shimizu, Junko Fujisaki, Masami Omae, Akira Yamasaki, Yusuke Horiuchi, Akiyoshi Ishiyama, Toshiyuki Yoshio, Toshiaki Hirasawa, Yorimasa Yamamoto, Tomohiro Tsuchida
BACKGROUND: In recent years, effective outcomes of endoscopic submucosal dissection (ESD) for esophagogastric junction cancer including short-segment Barrett's esophagus (SSBE) cancer have been reported. However, the efficacy of ESD for long-segment Barrett's esophagus (LSBE) cancer is unknown. AIM: To clarify the treatment outcomes of ESD for LSBE cancer versus SSBE cancer. METHODS: A total of 86 patients with 91 superficial Barrett's esophageal adenocarcinomas who underwent ESD were enrolled; of these, 68 had underlying SSBE and 18 had LSBE...
March 14, 2018: Digestion
Shiqi Wang, Shang Lin, Hu Wang, Jianjun Yang, Pengfei Yu, Qingchuan Zhao, Mengbin Li
BACKGROUND: The incidence of tumors located in the upper third of the stomach is increasing, and the use of radical proximal gastrectomy is becoming prevalent. After a proximal gastrectomy, various reconstructions are performed, but surgical outcomes are controversial. This study was performed to review clinical outcomes of reconstructions after proximal gastrectomy. METHODS: Inclusion criteria focused on postoperative complications of patients who underwent a proximal gastrectomy for gastric cancer...
March 2018: Medicine (Baltimore)
Patrick Sven Plum, Arnulf Heinrich Hölscher, Kristin Pacheco Godoy, Henner Schmidt, Felix Berlth, Seung-Hun Chon, Hakan Alakus, Elfriede Bollschweiler
BACKGROUND: The aim of this retrospective study was to compare the prognosis of patients with esophageal cancer after non-curative endoscopic resection (ER) followed by esophagectomy (ER + S) with that of patients after primary surgery (PS). METHODS: Between 2000 and 2015, 287 patients had esophagectomy for T1 esophageal cancer. 81 of these patients underwent at least one ER in curative intention before surgery (7 squamous cell carcinomas, 74 adenocarcinomas)...
March 13, 2018: Surgical Endoscopy
Lucas W Thornblade, Douglas E Wood, Michael S Mulligan, Alexander S Farivar, Michal Hubka, Kimberly E Costas, Bahirathan Krishnadasan, Farhood Farjah
OBJECTIVE: Prior studies have reported underuse of-but not variability in-invasive mediastinal staging in the pretreatment evaluation of patients with lung cancer. We sought to compare rates of invasive mediastinal staging for lung cancer across hospitals participating in a regional quality improvement and research collaborative. METHODS: We conducted a retrospective study (2011-2013) of patients undergoing resected lung cancer from the Surgical Clinical Outcomes and Assessment Program in Washington State...
February 9, 2018: Journal of Thoracic and Cardiovascular Surgery
Junko Aida, Tatsuro Ishizaki, Tomio Arai, Kaiyo Takubo
Endoscopic resection (ER) has become the standard therapy for superficial Barrett's carcinoma (BC) in Japan and other countries. Patients undergoing ER sometimes require additional treatment because of recurrence of lymph node metastasis (LNM). We attempted to clarify the histopathologic risk factors for LNM, and the difference between these risk factors for Japanese patients and the conventional risk factors documented for Western patients. This multi-center study included 12 leading institutions belonging to the Japan Research Society for Early Esophageal Cancer and Chromoendoscopy, and was based on a questionnaire designed to gather data on the features of superficial BC cases, except for high-grade intraepithelial neoplasia, treated at those institutions...
March 10, 2018: Human Pathology
Guoqing Jiang, Dousheng Bai, Ping Chen, Jianjun Qian, Shengjie Jin
BACKGROUND: Liver resection was not formerly recommended in patients with both hepatocellular carcinoma (HCC) and portal hypertension because of difficult perioperative bleeding control and postoperative liver failure. Splenectomy is a proven method with which to overcome these problems. To investigate the safety and feasibility of synchronous laparoscopic splenectomy and azygoportal disconnection with hepatectomy (LSDH) for treatment of portal hypertension accompanied with HCC, we describe a clinical cohort of 10 patients who underwent a new technique of synchronous LSDH...
March 1, 2018: Surgical Innovation
Yusuke Tonai, Ryu Ishihara, Yasushi Yamasaki, Masamichi Arao, Taro Iwatsubo, Minoru Kato, Syo Suzuki, Kenta Hamada, Satoki Shichijo, Noriko Matsuura, Takashi Kanesaka, Hiroko Nakahira, Sachiko Yamamoto, Tomofumi Akasaka, Noboru Hanaoka, Yoji Takeuchi, Koji Higashino, Noriya Uedo, Yasuhiko Tomita, Hiroyasu Iishi
Background and aim:  Strictures are a major complication of esophageal endoscopic submucosal dissection (ESD) for superficial esophageal carcinoma. Post ESD, stricture develops during the process of scar formation, which is related to inflammation caused by ESD. We planned a study to evaluate whether certain electrosurgical unit modes could attenuate strictures after esophageal ESD. Methods:  A total of 16 ESD, three-quarters of the esophageal circumference, were performed in four live pigs...
March 2018: Endoscopy International Open
Katsumi Yamamoto, Hiroshi Noro, Yu Sato, Akira Kusakabe, Nobuyuki Tatsumi, Tomoki Michida, Toshifumi Ito
Background and study aims  A 70-year-old-man underwent an esophagectomy and posterior mediastinal reconstruction for esophageal cancer that was curatively resected. Although the patient was allowed to eat after surgery, he repeatedly vomited after drinking water or eating meals and required continuous hospitalization. An upper gastrointestinal series and endoscopic examination revealed an obstruction due to the flexure of the gastric conduit, which was repeatedly treated with endoscopic balloon dilation. Endoscopic balloon dilation was completely ineffective, however, because the obstruction was not due to a small lumen diameter, but rather to severe flexure...
March 2018: Endoscopy International Open
Nabil Wasif, David Etzioni, Elizabeth B Habermann, Amit Mathur, Barbara A Pockaj, Richard J Gray, Yu-Hui Chang
BACKGROUND: Regionalization of complex visceral surgery across the United States has followed identification of a volume-outcome association. However, a simultaneous trend towards improved surgical outcomes may have attenuated this relationship. We hypothesize that the difference in adjusted postoperative mortality between low, medium and high volume hospitals has decreased over time. STUDY DESIGN: The National Inpatient Sample (NIS) was used to identify patients undergoing bladder, esophageal, pancreatic, liver, lung, and rectal surgery from 2003-2011...
March 7, 2018: Journal of the American College of Surgeons
L R van der Werf, J L Dikken, M I van Berge Henegouwen, V E P P Lemmens, G A P Nieuwenhuijzen, B P L Wijnhoven
BACKGROUND: For esophageal cancer, the number of retrieved lymph nodes (LNs) is often used as a quality indicator. The aim of this study is to analyze the number of retrieved LNs in The Netherlands, assess factors associated with LN yield, and explore the association with short-term outcomes. This is a population-based study on lymph node retrieval in patients with esophageal cancer, presenting results from the Dutch Upper Gastrointestinal Cancer Audit. STUDY DESIGN: For this retrospective national cohort study, patients with esophageal carcinoma who underwent esophagectomy between 2011 and 2016 were included...
March 9, 2018: Annals of Surgical Oncology
Yue Wu, Haihui Zhang, Bingxi Zhou, Shuangyin Han, Yanrui Zhang
Objective: The objective of this study was to evaluate the clinical value of endoscopic submucosal dissection (ESD) in the treatment of early esophageal cancer and precancerous lesions. Materials and Methods: We retrospectively analyzed 58 patients who suffered from early esophageal and precancerous lesions and received ESD in the First Affiliated Hospital of Zhengzhou University from February 2012 to January 2016. The clinical efficacy and safety of ESD in treating the early esophageal cancer and precancerous lesions was evaluated by analyzing the operation successful rate, postoperative pathology, complications, and follow-up data of patients who received ESD...
January 2018: Journal of Cancer Research and Therapeutics
Constantinos Roufas, Dimitrios Chasiotis, Anestis Makris, Christodoulos Efstathiades, Christos Dimopoulos, Apostolos Zaravinos
Background: Recently, immune-checkpoint blockade has shown striking clinical results in different cancer patients. However, a significant inter-individual and inter-tumor variability exists among different cancers. The expression of the toxins granzyme A (GZMA) and perforin 1 (PRF1), secreted by effector cytotoxic T cells and natural killer (NK) cells, were recently used as a denominator of the intratumoral immune cytolytic activity (CYT). These levels are significantly elevated upon CD8+ T-cell activation as well as during a productive clinical response against immune-checkpoint blockade therapies...
2018: Frontiers in Oncology
Saverio La Francesca, Johnathon M Aho, Matthew R Barron, Ellen W Blanco, Sherif Soliman, Lena Kalenjian, Ariel D Hanson, Elisaveta Todorova, Matthew Marsh, KaLia Burnette, Harout DerSimonian, Robert D Odze, Dennis A Wigle
Treatment of esophageal disease can necessitate resection and reconstruction of the esophagus. Current reconstruction approaches are limited to utilization of an autologous conduit such as stomach, small bowel, or colon. A tissue engineered construct providing an alternative for esophageal replacement in circumferential, full thickness resection would have significant clinical applications. In the current study, we demonstrate that regeneration of esophageal tissue is feasible and reproducible in a large animal model using synthetic polyurethane electro-spun grafts seeded with autologous adipose-derived mesenchymal stem cells (aMSCs) and a disposable bioreactor...
March 7, 2018: Scientific Reports
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