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Esophageal Surgery

M Koëter, M van Putten, R H A Verhoeven, V E P P Lemmens, G A P Nieuwenhuijzen
BACKGROUND: The aim of our study was to describe treatment patterns and the impact on overall survival among elderly patients (75 years and older) with potentially curable esophageal cancer. MATERIAL AND METHODS: Between 2003 and 2013, 13,244 patients from the nationwide population-based Netherlands Cancer Registry (NCR) were diagnosed with potentially curable esophageal cancer (cT2-3, X, any cN, cM0, X) of which 34% were elderly patients (n = 4501). RESULTS: Surgical treatment with or without neoadjuvant treatment remained stable among elderly patients (around the 16% between 2003 and 2013)...
March 12, 2018: Acta Oncologica
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
Yukihiro Kaneko, Ken-Ichi Oinuma, Tsuneko Terachi, Yasuaki Arimura, Mamiko Niki, Koichi Yamada, Hiroshi Kakeya, Tetsu Mizutani
A 53-year-old woman was hospitalized due to septic shock after developing pneumococcal pneumonia after undergoing esophageal cancer surgery. Her transverse colon became perforated after receiving antimicrobial chemotherapy; therefore, emergency subtotal colectomy was performed. Fungi detected in both her colon tissue and a drainage sample indicated intestinal mucormycosis. Early intensive treatment with high-dose liposomal amphotericin B was successful, and she was subsequently discharged from the hospital...
March 9, 2018: Internal Medicine
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
Abirami Kumaresan, Robert Gerber, Ariel Mueller, Stephen H Loring, Daniel Talmor
BACKGROUND: The effects of prone positioning on esophageal pressures have not been investigated in mechanically ventilated patients. Our objective was to characterize effects of prone positioning on esophageal pressures, transpulmonary pressure, and lung volume, thereby assessing the potential utility of esophageal pressure measurements in setting positive end-expiratory pressure (PEEP) in prone patients. METHODS: We studied 16 patients undergoing spine surgery during general anesthesia and neuromuscular blockade...
March 9, 2018: Anesthesiology
Romano Schneider, Ioannis Lazaridis, Marko Kraljević, Christoph Beglinger, Bettina Wölnerhanssen, Ralph Peterli
BACKGROUND: Despite the increasing use of bariatric surgery as the most effective treatment of morbid obesity, there is still no consensus on its preoperative diagnostic workup. The aim of this study was to identify the pathologies of the endoscopic and radiologic investigations before performing bariatric surgery and to evaluate their impact on the patient management. METHODS: Retrospective analysis of prospectively collected data of 1225 consecutive patients who underwent laparoscopic Roux-en-Y gastric bypass (n = 834) or sleeve gastrectomy (n = 391) at our institution...
January 12, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Mackenzie C Lees, Ioana Bratu, Maryna Yaskina, Michael van Manen
PURPOSE: The purpose of this study was to explore oral feeding outcomes in infants born with type-C esophageal atresia and tracheoesophageal fistula (EA/TEF). METHODS: A retrospective cohort study of all infants born between January 2005 and December 2015 undergoing surgery for type-C EA/TEF at the University of Alberta Hospital was performed. RESULTS: Fifty-seven infants were identified, of which 61.4% were exclusively orally feeding at discharge home...
February 7, 2018: Journal of Pediatric Surgery
Tresson Philippe, Ballabio Fabrizia, Manceau Gilles, Adam Nicolas, Lawton James, Davaine Jean-Michel, Koskas Fabien
Pseudoaneurysm due to a swallowed fish bone rarely involves subclavian arteries. A 46-year-old male with non-aberrant right subclavian artery presented pseudoaneurysm and brachial plexus septic necrosis. Open surgery with sternotomy and right transverse supraclavicular cervicotomy was done in emergency to achieve revascularization by in situ cryopreserved arterial allograft. Infection severity led to septic allograft rupture that necessitated ligation without new arterial reconstruction. During follow-up patient remained alive 8 months after surgery...
March 5, 2018: Annals of Vascular Surgery
Seong Yong Park, Jee Won Suh, Dae Joon Kim, Jun Chul Park, Eun Hye Kim, Chang Young Lee, Jin Gu Lee, Hyo Chae Paik, Kyoung Young Chung
BACKGROUND: It is still unclear that dissection of recurrent laryngeal nerve nodes is mandatory in patients with cT1 middle or lower thoracic esophageal squamous cell carcinoma when the nodes are negative in preoperative staging work-up. We aimed to evaluate the feasibility of near-infrared image-guided lymphatic mapping of bilateral recurrent laryngeal nerve nodes. METHODS: The day before surgery, we injected indocyanine green (ICG) into submucosal layer by endoscopy...
March 5, 2018: Annals of Thoracic Surgery
Praneet Wander, Daniel Castaneda, Lionel D'Souza, Simi Singh, Sam Serouya, Ana I Velazquez, Rifat Mamun, Rebecca Voaklander, Petros Benias, David L Carr-Locke
BACKGROUND: To assess the safety and efficacy of the Instinct clip in the acute endoscopic treatment of upper gastrointestinal bleeding (UGIB). MATERIALS AND METHODS: This is the first large series reporting this clip in achieving hemostasis. A retrospective descriptive chart review was performed on patients presenting with recent overt GI bleeding treated with endoclip therapy at Mount Sinai Beth Israel Medical Center between May 2013 and January 2016. Results are expressed in absolute numbers, percentages, and trends...
April 2018: Journal of Clinical Gastroenterology
Paula Martins, Cid Sergio Ferreira, José Renan Cunha-Melo
The aim of this study was to determine the esophageal transit time in control individuals and in chagasic patients with or without megaesophagus.A total of 148 patients were allocated in 6 groups according to serological diagnostic of Chagas disease and the degree of esophageal dilatation: A, control healthy individuals (n = 34, 22.9%); B, indeterminate form (n = 23, 15.5%); C, megaesophagus I (n = 37, 25.0%); D, megaesophagus II (n = 19, 12.8%); E, megaesophagus III (n = 21, 14.2%); and F, megaesophagus IV (n = 14, 9...
March 2018: Medicine (Baltimore)
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
T-W Chuang, S-C Chen, K-T Chen
AIMS: The aim of this study was to explore the recent advances in diagnosis and treatment of gastroesophageal reflux disease (GERD). METHODS: Previous studies were searched using the terms "gastroesophageal reflux disease" and "diagnosis" or "treatment" in Medline and Pubmed. Articles that were not published in the English language, manuscripts without an abstract, reviews, meta-analysis, and opinion articles were excluded from the review...
July 2017: Acta Gastro-enterologica Belgica
Ingmar L Defize, Bernadette Schurink, Teus J Weijs, Tom A P Roeling, Jelle P Ruurda, Richard van Hillegersberg, Ronald L A W Bleys
BACKGROUND: Injury and subsequent leakage of unrecognized thoracic duct tributaries during transthoracic esophagectomy may lead to chylothorax. Therefore, we hypothesized that thoracic duct anatomy at the diaphragm is more complex than currently recognized and aimed to provide a detailed description of the anatomy of the thoracic duct at the diaphragm. BASIC PROCEDURES: The thoracic duct and its tributaries were dissected in 7 (2 male and 5 female) embalmed human cadavers...
March 3, 2018: Annals of Anatomy, Anatomischer Anzeiger: Official Organ of the Anatomische Gesellschaft
Elena Adelina Toma, Mohammad Oun, Octavian Enciu, Valentin Calu, Adrian Miron
Esophageal foreign bodies are a relatively frequent pathology which does not need any kind of treatment in up to 80% of cases. Ten to 20% of patients are treated endoscopically, while less than 1% need surgery either due to perforation or to treat complications. We address the case of a 50 year old male who presented with an impacted esophageal foreign body which had perforated the esophageal wall. Flexible endoscopy confirmed the diagnosis and identified a large fish bone that was stuck transversally in the distal cervical esophagus and could not be mobilized...
January 2018: Chirurgia
Cristina Gîndea, Adrian Constantin, Petre Hoară, Andrei Cărăgui, Abdullah AlKadour, Silviu Constantinoiu
Introduction: Thoracic esophageal diverticulum is a rare pathology frequently associated with esophageal motility disorders. Surgery is the only option in patients with severe symptoms. METHOD: This is a retrospective case series study of 10 patients who underwent diverticulectomy for thoracic (epiphrenic or mid-esophageal) diverticula. It was recorded: main preoperative symptoms, usual blood tests, barium swallow, upper endoscopy and esophageal manometry. We analyzed the postoperative complications, length of stay in hospital and intensive care unit...
January 2018: Chirurgia
Rodica Anghel, Silviu Constantinoiu, Xenia Bacinschi, Laurentia Gales, Radu-Valeriu Toma, Oana Trifanescu
Background: Combined modality therapy has been employed for the treatment of choice for locally advanced esophageal and eso-gastric junction cancers all around the globe but a unanimous consensus is missing. Methods: Medical files of 132 patients with confirmed locally advanced un-resectable, and metastatic esophageal cancer who presented to our center between 2010-2015 were retrospectively reviewed. Multimodality treatment consisting of chemo-radiotherapy or chemotherapy or radiotherapy alone and surgery in patients who convert to operability was planned according to tumor extend and performance status of the patient...
January 2018: Chirurgia
Denisa Oprisanescu, Denisa Bucur, Vasile Sandru, Ioan Cristian Nedelcu, Madalina Ilie, Ruxandra Oprita, Gabriel Constantinescu
Non-malignant esophageal fistulas have a wide spectrum of clinical and pathological features and it`s important to learn to detect and treat them, due to significant morbidity, mortality and costs. The need for minimally invasive, efficient and also quick procedures is imperative. Esophageal stenting using fully-covered expandable stents has become an increasingly preferred option and addresses to fistulas which arise from 2-3 cm beyond Killian's mouth and up to the gastroesophageal junction. The long-term purpose of the procedure is closure of the fistula and thus healing...
January 2018: Chirurgia
Ionuţ Hutopilă, A Constantin, Cătălin Copăescu
Background: Obesity has significantly increased in the last decades and metabolic (bariatric) surgery has been extended accordingly. Clinical manifestations of Gastroesophageal reflux disease (GERD) are frequent in the obese population but the presence of GERD premises (i.e. Hiatala hernia) or complications in asymptomatic patients undergoing metabolic surgery is unclear. AIM: (1) to identify gastroesophageal reflux condition or complications in patients undergoing metabolic surgery. (2) Study the correlations of the clinical symptoms of GERD with the preoperative radiological and endoscopic findings...
January 2018: Chirurgia
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