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Esophageal anastomosis

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https://www.readbyqxmd.com/read/29452856/generalized-cardiovascular-disease-on-a-preoperative-ct-scan-is-predictive-for-anastomotic-leakage-after-esophagectomy
#1
Alicia S Borggreve, Lucas Goense, Peter S N van Rossum, Richard van Hillegersberg, Pim A de Jong, Jelle P Ruurda
BACKGROUND: Recent studies demonstrated that calcification of arteries supplying the gastric tube is associated with anastomotic leakage after esophagectomy. However, it remains unclear whether this association only derives from local flow limitations, or generalized vascular disease as well. The purpose of this study was to determine whether calcification throughout the entire cardiovascular system is associated with anastomotic leakage. METHODS: Consecutive patients who underwent an esophagectomy with gastric tube reconstruction and cervical anastomosis for esophageal cancer were analyzed...
February 2, 2018: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29421911/intrathoracic-leak-after-an-ivor-lewis-procedure-for-an-esophageal-neoplasm-treated-with-a-stent
#2
Natalia Afonso Luis, Maria Asunsión Acosta Mérida, Joaquín Marchena Gómez
A 75-year-old male who underwent an Ivor Lewis esophagectomy due to a distal adenocarcinoma had a leak at the gastroplasty on the 5th day after surgery, which required two surgeries and a primary suture. He was transferred to our hospital due to a poor outcome and endoscopy revealed a 2.5cm gap perianastomotically on the gastroplasty wall, for which a stent was placed. Due to hemodynamic impairment, a thoracotomy procedure was performed, which revealed stent protrusion into the cavity. The patient underwent an esophagogastric anastomosis resection, cervical esophagostomy and gastrostomy...
February 9, 2018: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29417405/salvage-surgery-for-esophageal-cancer-how-to-improve-outcomes
#3
Charlotte Cohen, Williams Tessier, Caroline Gronnier, Florence Renaud, Arnaud Pasquer, Jérémie Théreaux, Johan Gagnière, Bernard Meunier, Denis Collet, Guillaume Piessen, Christophe Mariette
BACKGROUND: Locoregional recurrence rates after definitive chemoradiotherapy (dCRT) for locally advanced esophageal cancer (EC) are high. Salvage surgery (SALV) is considered the best treatment option in case of persistent or recurrent disease for operable patients, but SALV has been associated with increased morbidity and mortality. The aim of this study is to identify factors linked to outcomes after SALV to better select candidates and to optimize perioperative care. STUDY DESIGN: We retrospectively analyzed data from 308 consecutive SALV patients from a large multicenter European cohort...
February 7, 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29395153/elongation-of-esophageal-segments-by-bougienage-stretching-technique-for-long-gap-esophageal-atresia-to-achieve-delayed-primary-anastomosis-by-thoracotomy-or-thoracoscopic-repair-a-first-experience-from-china
#4
Suna Sun, Weihua Pan, Wenjie Wu, Yiming Gong, Jia Shi, Jun Wang
OBJECTIVES: The treatment of long gap esophageal atresia (LGEA) is one of the most challenging congenital malformations in neonatal surgery. A preoperative bougienage stretching technique for elongation of the two segments of esophagus is applied to achieve utilizing the native esophagus to establish esophageal continuity by open or thoracoscopic approach. METHODS: From January 2015 to May 2017, 12 neonates who suffered from LGEA were admitted to our department...
December 27, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29394716/-four-cases-of-gastrointestinal-perforation-associated-with-bevacizumab
#5
Kazuhito Uemura, Hiroaki Takahashi, Kazuhiro Mino, Takuji Ota, Shunsuke Shichi
Four cases of gastrointestinal perforation associated with bevacizumab(BEV)were examined. Case 1: A 82-year-old male received FOLFIRI plus BEV for recurrent liver metastasis after rectal cancer resection. A lower esophageal perforation occurred 22 days after BEV administration and drainage was performed. Case 2: A 69-year-old female received FOLFOX4 plus BEV for unresectable rectal cancer and liver and lung metastasis. A rectal perforation occurred 6 days after BEV administration and suturing closure of the hole and colostomy was performed...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29340552/single-anastomosis-gastric-bypass-one-anastomosis-gastric-bypass-or-mini-gastric-bypass-the-experience-with-billroth-ii-must-be-considered-and-is-a-challenge-for-the-next-years
#6
Italo Braghetto, Attila Csendes
INTRODUCTION: Single anastomosis gastric bypass (one anastomosis gastric bypass or mini-gastric bypass) has been presented as an option of surgical treatment for obese patients in order to reduce operation time and avoiding eventual postoperative complications after Roux-en-Y gastric bypass.The main late complication could be related to bile reflux. AIM: To report the experiences published after Billroth II anastomosis and its adverse effects regarding symptoms and damage on the gastric and esophageal mucosa ...
October 2017: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/29312708/substernal-reconstruction-following-esophagectomy-operation-of-last-resort
#7
Jacob R Moremen, DuyKhanh P Ceppa, Karen M Rieger, Thomas J Birdas
Background: The posterior mediastinum is the preferred location for reconstruction following esophagectomy. Occasionally alternative routes are required. We examined patient outcomes of esophageal reconstruction in order to determine whether substernal reconstruction (SR) is an equivalent alternative to orthotopic placement. Methods: Following IRB approval, we performed a retrospective review of all patients who underwent an esophagectomy from 1988-2014. Only patients reconstructed with a gastric conduit and cervical anastomosis by either substernal or posterior mediastinal (PM) routes were included in the study...
December 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29279556/lymphangiography-was-useful-in-postoperative-intractable-chylothorax-after-surgery-for-esophageal-cancer-a-case-report
#8
Takeshi Shimakawa, Yoshihiko Naritaka, Miki Miyazawa, Shinichi Asaka, Asako Shimazaki, Kentaro Yamaguchi, Hajime Yokomizo, Kazuhiko Yoshimatsu, Shunichi Shiozawa, Takao Katsube
Postoperative chylothorax after surgery for esophageal cancer is a rare but serious complication. Treatment initially consists of conservative therapy and, if it fails to provide improvement, it is important to perform surgical treatment without delay. We report on a recent case of intractable chylothorax. This report describes a 72-year-old man with Stage III esophageal squamous cell carcinoma. Subtotal esophagectomy, through a right thoracoabdominal approach with two-field lymphadenectomy, and cervical esophagogastric anastomosis via the retrosternal route, were performed...
2017: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
https://www.readbyqxmd.com/read/29224798/slide-esophagoplasty-vs-end-to-end-anastomosis-for-recalcitrant-esophageal-stricture-after-esophageal-atresia-repair
#9
Ali Kamran, Charles J Smithers, Michael A Manfredi, Thomas E Hamilton, Peter D Ngo, David Zurakowski, Russell W Jennings
BACKGROUND: Anastomotic stricture is a common complication following esophageal atresia (EA) repair. Patients with a recalcitrant stricture may require surgical intervention. The technique of re-anastomosis after stricture resection can affect patient outcomes. STUDY DESIGN: EA patients who underwent anastomotic stricture resection from July 2010 to February 2017 were reviewed. Patients after stricture resection in which slide esophagoplasty was performed were compared to the conventional approach of end-to-end anastomosis...
December 7, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29203406/acid-and-nonacid-gastroesophageal-reflux-after-single-anastomosis-gastric-bypass-an-objective-assessment-using-24-hour-multichannel-intraluminal-impedance-ph-metry
#10
Georgia Doulami, Stamatina Triantafyllou, Konstantinos Albanopoulos, Maria Natoudi, Georgios Zografos, Dimitrios Theodorou
BACKGROUND: Single anastomosis gastric bypass (SaGB) was introduced in 2001 as an alternative to "loop" gastric bypass. It was considered as a procedure that would eliminate alkaline reflux and associated esophagitis. OBJECTIVES: Existing evidence about the postoperative incidence of gastroesophageal reflux (GERD) after SaGB is based on studies using symptom questionnaires. The aim of our study was to evaluate GERD 12 months after SaGB by using 24-hour multichannel intraluminal impedance pH metry (24-h MIIpH)...
October 26, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29191359/evaluation-of-esophageal-anastomotic-integrity-with-serial-pleural-amylase-levels
#11
Daniel L Miller, Gerald A Helms, William R Mayfield
BACKGROUND: An anastomotic leak is the most devastating and potentially fatal complication after esophagectomy. Current detection methods can be inaccurate and place patients at risk of other complications. Analysis of pleural fluid for amylase may be more accurate and place patients at less of a risk for evaluating the integrity of an esophageal anastomosis. METHODS: We retrospectively reviewed prospective data of 45 consecutive patients who underwent an Ivor Lewis esophagectomy over an 18-month period and evaluated their anastomotic integrity with serial pleural amylase levels (PAL)...
January 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29166132/imaging-of-iatrogenic-esophageal-injuries-using-optimized-ct-esophageal-leak-protocol-pearls-and-pitfalls
#12
Rachna Madan, Olga Laur, Breland Crudup, Latia Peavy, Brett W Carter
Iatrogenic injury to the esophagus is a serious complication which is increasingly seen in clinical practice secondary to expansion and greater acceptability of surgical and endoscopic esophageal procedures. Morbidity and mortality following such injury is high. This is mostly due to an inflammatory response to gastric contents in the mediastinum, and the negative intra-thoracic pressures that may further draw out esophageal contents into the mediastinum leading to mediastinitis. Subsequently, pulmonary complications such as pneumonia or abscess may ensue leading to rapid clinical deterioration...
November 22, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/29145294/recurrent-tracheoesophageal-fistula-in-an-adolescent-without-persistent-symptoms-a-case-report
#13
Jun-Hong Lin, Li Deng, Xing Li
RATIONALE: Congenital esophageal atresia (EA) and tracheoesophageal fistula (TEF) ininfants have been treated well with surgery. Approximately 10% of children displayed recurrent fistula. In the present case, we reported recurrent TEF in an adolescent as a complication of EA/TEF in infancy. PATIENT CONCERNS: An infant was diagnosed with gross type C congenital EA and TEF and subsequentlyunderwent repair in early infancy, with division of the TEF and primary esophageal anastomosis...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29134504/ketorolac-and-other-nsaids-increase-the-risk-of-anastomotic-leakage-after-surgery-for-gej-cancers-a-cohort-study-of-557-patients
#14
Kaare Terp Fjederholt, Cecilie Okholm, Lars Bo Svendsen, Michael Patrick Achiam, Jakob Kirkegård, Frank Viborg Mortensen
OBJECTIVE: The objective of this study is to investigate the impact of ketorolac and other nonsteroidal anti-inflammatory drugs on anastomotic leakage after surgery for gastro-esophageal-junction cancer. Within the last two decades, the incidence of gastro-esophageal-junction cancer has increased in the western world and surgery is the curative treatment modality of choice. Anastomotic leakage is a feared complication of gastro-esophageal surgery, as it increases recurrence, morbidity, and mortality...
November 13, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29131024/evaluation-of-anastomotic-leak-after-esophagectomy-for-esophageal-cancer-typical-time-point-of-occurrence-mode-of-diagnosis-value-of-routine-radiocontrast-agent-studies-and-therapeutic-options
#15
Benjamin Struecker, Andreas Andreou, Sascha Chopra, Ann-Christin Heilmann, Johanna Spenke, Christian Denecke, Igor Maximilian Sauer, Marcus Bahra, Johann Pratschke, Matthias Biebl
BACKGROUND: Data on the typical time point of occurrence of anastomotic leak (AL) after esophagectomy for esophageal cancer are currently scarce. Therefore, the usefulness of routine radiocontrast agent studies (RRCS) for testing proper healing of the anastomosis after esophagectomy remains unclear. Furthermore, preferred available tools to diagnose postoperative AL and therapeutic options are still under debate. METHODS: We present a retrospective analysis of 328 consecutive patients who underwent esophagectomy for esophageal cancer between 2005 and 2015...
November 7, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/29130643/pilot-study-on-preventing-anastomotic-leakage-in-stapled-gastroesophageal-anastomosis
#16
Shijie Zhang, Weiming Huang, Xiangzheng Liu, Jian Li
BACKGROUND: This study explored how to improve the surgical technique to reduce or avoid anastomotic leakage. METHODS: From January 2012 to December 2016, 101 consecutive patients with cancer of the esophagus or gastroesophageal junction underwent stapled gastroesophageal anastomosis. The procedure included creating a tube-type stomach, fixing an inserted anvil, inspecting mucosa-to-mucosa alignment in the lumen under direct vision after firing the stapler, and, if found, manually repairing a rupture of the mucous membrane of the anastomosis...
November 11, 2017: Thoracic Cancer
https://www.readbyqxmd.com/read/29124403/esophagoesophagopexy-technique-for-assisted-fistulization-of-esophageal-atresia
#17
Isabelle Chumfong, Hanmin Lee, Benjamin E Padilla, Tippi C MacKenzie, Lan T Vu
PURPOSE: We describe our experience using a modified suture fistula technique for addressing tension in longer gap esophageal atresia (EA). Esophagoesophagopexy (EEP) is the tacking of the proximal and distal ends of esophageal pouches without formal anastomosis. In this retrospective cohort, we review the outcomes of patients with EA after EEP. METHODS: We reviewed the operative reports of EA cases treated at our institution from 1997 to 2016 and identified all patients described as having EEP...
November 9, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/29117903/histopathological-and-immunohistochemical-analysis-of-the-use-of-collagen-dressing-as-a-reinforcement-of-esophagic-anastomosis-in-a-rat-experimental-model
#18
Rocio Garcia-Perez, Vicente Munitiz, Carlos Manuel Martinez-Caceres, David Ruiz de Angulo, Angeles Ortiz, Luisa F Martinez de Haro, Diana Navas, Pascual Parrilla
INTRODUCTION: One of the most severe complications after esophaguectomy is anastomotic dehiscence. The use of collagen sponges could be an effective way to resolve this complication. Our objective was to perform an experimental model of esophageal anastomosis in rats to study these mechanisms. METHODS: A total of 50 Sprague-Dawley rats were used divided into 2 groups, Tachosil(®) group (n=25) and control group (n=25). After the section of the abdominal esophagus a single-layer esophago-gastric anastomosis was performed reinforced with 1cm of Tachosil(®) wrapping the anastomosis in group 1...
November 5, 2017: Cirugía Española
https://www.readbyqxmd.com/read/29100176/a-left-thoracic-approach-in-a-prone-position-for-thoracoscopic-thoracic-duct-ligation-in-a-patient-with-post-esophagectomy-chylothorax-a-case-report
#19
Kiyotomi Maruyama, Kou Shimada, Toshikazu Hamanaka, Shinsuke Sugenoya, Kuniyuki Gomi, Motohiro Mihara, Shoji Kajikawa, Yusuke Sato
INTRODUCTION: We debate whether or not to approach from right thorax for the left chylothorax after esophagectomy. PRESENTATION OF CASE: A 50s-year-old female underwent right-sided thoracoscopic esophagectomy with three-field lymphadenectomy for esophageal carcinoma (type 0-IIa, 3.4×2.2cm, T1bN0M0, Stage IA), followed by reconstruction with esophagogastric anastomosis through the posterior mediastinum. The thoracic duct was excised and ligated. The left thoracic drainage increased to 2115mL/day on the fifth postoperative day...
October 24, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29069877/is-robot-assisted-surgery-really-scarless-surgery-immediate-reconstruction-with-a-jejunal-free-flap-for-esophageal-rupture-after-robot-assisted-thyroidectomy
#20
Seong Hoon Park, Joo Hyun Kim, Jun Won Lee, Hii Sun Jeong, Dong Jin Lee, Byung Chun Kim, In Suck Suh
Esophageal perforation is a rare but potentially fatal complication of robot-assisted thyroidectomy (RAT). Herein, we report the long-term outcome of an esophageal reconstruction with a jejunal free flap for esophageal rupture after RAT. A 33-year-old woman developed subcutaneous emphysema and hoarseness on postoperative day1 following RAT. Esophageal rupture was diagnosed by computed tomography and endoscopy, and immediate surgical exploration confirmed esophageal rupture, as well as recurrent laryngeal nerve injury...
November 2017: Archives of Plastic Surgery
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