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Esophagus stent

Nikolaus Pfisterer, Florian Riedl, Thomas Pachofszky, Michael Gschwantler, Kurt König, Benjamin Schuster, Mattias Mandorfer, Irina Gessl, Constanze Illiasch, Eva-Maria Fuchs, Lukas Unger, Werner Dolak, Andreas Maieron, Ludwig Kramer, Christian Madl, Michael Trauner, Thomas Reiberger
BACKGROUND: Current guidelines favour the use of bleeding stents over balloon tamponade (BT) for refractory variceal bleeding (VB) from oesophageal varices. However, data on the efficacy and safety of self-expandable metal SX-ELLA Danis stents (SEMS) are limited. METHODS: Cirrhotic patients receiving SEMS for VB at four tertiary care centres were included in this retrospective multicentre study. Rates of failure-to-control bleeding (within 5 days) and bleeding-related mortality (6 weeks) were assessed...
September 24, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
Nathan S Rubalcava, Jenna L Sitenga, Vincent A Gemma, Kevin P McGeever, Ross M Bremner
A 42-year-old man presented to the emergency department with gunshot wound to left upper back over the scapula and palpable bullet over the right supraclavicular fossa. The patient had a left-sided needle thoracostomy in the field. He was tachypneic and tachycardiac but normortensive on arrival. Due to the patient being in respiratory distress, he was orotracheally intubated. On examination, he was found to have a moderate left pneumothorax with mild mediastinal shift. He had a left closed tube thoracostomy placed...
2018: Trauma surgery & acute care open
Kopelman Y, Abu Baker F, Troiza A, Hebron D
Boerhaave syndrome refers to a spontaneous perforation of the esophagus that results from severe straining or vomiting. This uncommon situation may lead to serious outcome with chemical mediastinitis, and is associated with high morbidity and mortality. Surgery, although associated with high morbidity and mortality remains the treatment of choice, whereas endoscopic management with stent placement is preserved to treat inoperable patients. Removal of the stent is generally recommended after 4-6 weeks. We report a case of an elderly patient who presented with a large complicated Boerhaave's mid-esophageal perforation, with a complete recovery after a 3-month treatment with a long esophageal stent...
October 2018: Radiology Case Reports
Yonghua Bi, Jindong Li, Hongmei Chen, Xinwei Han, Gang Wu, Jianzhuang Ren
To determine the safety and effectiveness of fluoroscopic guidance biopsy in the diagnosis of serve anastomotic stricture after esophagogastrostomy for esophageal carcinoma.A total of 55 patients with severe anastomotic stricture were enrolled for forceps biopsy between June 2013 and July 2017. Chest computed tomography (CT) and esophagogram were used to determine the location and extent of stricture. Specimens were collected from the site of stricture by using biopsy forceps under fluoroscopic guidance. Stooler's dysphagia score was compared before and after treatment...
September 2018: Medicine (Baltimore)
Amit K Mahajan, Mia Newkirk, Carolyn Rosner, Sandeep J Khandhar
Tracheoesophageal fistulas (TEF) are pathologic communications between the esophagus and the trachea or bronchi. The development of a TEF can result from malignant or benign etiologies. A common approach for the treatment of TEFs is the placement of endobronchial and esophageal stents to facilitate healing of the communication. This case report describes the successful treatment of a TEF resulting from calcified mediastinal lymphadenopathy due to a previous Histoplasmosis capsulatum infection. In addition to placement of endobronchial and esophageal stents, the non-healing TEF was treated with ACell (Gentrix® ) decellularized porcine urinary bladder matrix to facilitate complete closure of the fistulous tract...
August 2018: Journal of Surgical Case Reports
Jung-Hoon Park, Wooram Park, Soojeong Cho, Kun Yung Kim, Jiaywei Tsauo, Sung Hwan Yoon, Woo Chan Son, Dong-Hyun Kim, Ho-Young Song
Current therapeutic strategies are insufficient for suppressing stent-induced restenosis. Here, branched gold nanoparticles (BGNP)-coated self-expandable metallic stents (SEMSs) were developed for a local heat-induced suppression of stent-related tissue hyperplasia. Our polydopamine (PDA) coating on SEMS allowed BGNP crystal growth on the surface of SEMSs. The prepared BGNP-coated SEMS showed effective local heating under near-infrared laser irradiation. The effectiveness of BGNP-coated SEMSs for suppressing stent-related tissue hyperplasia was demonstrated in a rat esophageal model ( n = 52)...
September 5, 2018: ACS Applied Materials & Interfaces
George S Georgiadis, Christos Argyriou, Andreas Koutsoumpelis, Fotios Konstantinou, Pelagia Chloropoulou, Ioannis Chrisafis, Vasileios Souftas
BACKGROUND: Although surgical resection and graft replacement therapy for thoracic aortic aneurysms has advanced greatly over the last 20 years, significant perioperative morbidity and mortality still occur, particularly in patients considered high risk due to significant coexisting medical illness or previous operations performed for the treatment of intrathoracic disease. METHODS: The case described is that of a patient with a giant (13.8 cm) symptomatic descending thoracic aorta aneurysm (DTAA), previously treated endovascularly 15 years ago...
August 4, 2018: Annals of Vascular Surgery
Hisaho Sato, Kaoru Ishida, Shusaku Sasaki, Masahiro Kojika, Shigeatsu Endo, Yoshihiro Inoue, Akira Sasaki
Stent migration, which causes issues in stent therapy for esophageal perforations, can counteract the therapeutic effects and lead to complications. Therefore, techniques to regulate stent migration are important and lead to effective stent therapy. Here, in these cases, we placed a removable fully covered self-expandable metallic stent (FSEMS) in a 52-year-old man with suture failure after surgery to treat Boerhaave syndrome, and in a 53-year-old man with a perforation in the lower esophagus due to acute esophageal necrosis...
July 28, 2018: World Journal of Gastroenterology: WJG
Gabriele Lisi, Maria Teresa Illiceto, Erminia Francesca Romeo, Giuseppe Lauriti, Simona Faraci, Giuliano Lombardi, Luigi DallʼOglio, Pierluigi Lelli Chiesa
OBJECTIVES: Disk battery esophageal retention in children younger than 6 years represents an increasing endoscopic emergency, followed by a relevant risk of life-threatening late complications. Surgical removal after a failed endoscopic approach is rarely reported in the literature. We describe our experience in this scenario. METHODS: Two female asymptomatic patients aged 26 and 29 months presented within 4 hours after a witnessed ingestion of a 2-cm, 3-V lithium battery (CR2032) retained in the cervical esophagus...
July 25, 2018: Pediatric Emergency Care
Juan J Gonzalez, Lakshmi Talasila, Lisa Ochoa, John Youssef, Orimisan S Adekolujo
Bronchoesophageal and tracheoesophageal fistulas are an uncommon but well-documented complication of Hodgkin lymphoma (HL). To our knowledge, a fistula directly connecting the esophagus with the lung (esophageal-pulmonary fistula) and resulting from HL has not been reported in the literature. We present a case of HL complicated with an esophageal-pulmonary fistula. The early recognition and treatment of an esophageal-pulmonary fistula in patients with HL are imperative since, with appropriate treatment, HL complicated with an aero-esophageal fistula has the same prognosis as those without one, unlike the dismal prognosis in esophageal and lung cancer...
May 7, 2018: Curēus
Hozhabr Mozafari, Pengfei Dong, Shijia Zhao, Yonghua Bi, Xinwei Han, Linxia Gu
OBJECTIVE: Stenting is one of the major treatments for malignant esophageal cancer. However, stent migration compromises clinical outcomes. A flared end design of the stent diminishes its migration. The goal of this work is to quantitatively characterize stent migration to develop new strategies for better clinical outcomes. METHODS: An esophageal stent with flared ends and a straight counterpart were virtually deployed in an esophagus with asymmetric stricture using the finite element method...
September 1, 2018: Computers in Biology and Medicine
Ana Puerta Vicente, Pablo Priego Jiménez, María Ángeles Cornejo López, Francisca García-Moreno Nisa, Gloria Rodríguez Velasco, Julio Galindo Álvarez, Eduardo Lobo Martínez
Esophageal perforation constitutes a surgical emergency. Despite its gravity, no single strategy has been described as sufficient to deal with most situations to date. The aim of this study was to assess the etiology, management, and outcome of esophageal perforation over a 28-year period, to characterize optimal treatment options in this severe disease. A retrospective clinical review of all patients treated for esophageal perforation at Ramón y Cajal Hospital between January 1987 and December 2015 was performed (n = 57)...
May 1, 2018: American Surgeon
Janusz R Włodarczyk, Jarosław Kużdżał
BACKGROUND: The aim of this study was to analyze the safety and effectiveness of stenting using partially covered self-expandable stents in palliation of dysphagia in patients with unresectable esophageal cancer. METHODS: Retrospective analysis of hospital records of all patients who underwent esophageal stenting in the period 2008-2015 was performed. The study included patients with unresectable esophageal and esophagogastric cancer. RESULTS: There were 442 patients included...
June 26, 2018: World Journal of Surgery
Michael A Manfredi, Susannah J Clark, Steven J Staffa, Peter D Ngo, C Jason Smithers, Thomas E Hamilton, Russell W Jennings
BACKGROUND: Esophageal perforation is a potentially life-threatening problem if not quickly diagnosed and treated appropriately. Negative pressure wound therapy (NPWT), commercially known as V.A.C.® therapy, was developed in the early 1990 s and is now standard of care for chronic surface wounds, ulcers, and burns. Adapting vacuum sponge therapy for use intraluminally for perforations of the esophagus was first reported in 2008. We report the first pediatric experience on a customized esophageal vacuum assisted closure (EVAC) device for closure of esophageal perforations...
June 20, 2018: Journal of Pediatric Gastroenterology and Nutrition
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...
October 2018: Endoscopy
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...
August 2018: Minerva Chirurgica
R Dolezel, B Walterová, S Juhas, O Ryska, J Juhásová, Z Vacková, J Krajciova, J Král, J Martínek
INTRODUCTION: Complete circular endoscopic (submucosal) resection (CER) performed using the endoscopic submucosal dissection (ESD) technique is burdened with a high incidence of post-operative strictures in the esophagus. The most effective method of preventing them is not known so far; one of the possible methods is to prevent these strictures directly at the site of their formation by covering the defect with a stent. The aim of the study was to find a way to fix a selected biomaterial to a stent, and subsequently, to fix the stent at the CER site to prevent esophageal strictures in an animal model...
2018: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
Laetitia Buemi, Salvatore Stefanelli, Philippe Bichard, Mickaël Luscher, Minerva Becker
BACKGROUND: Esophageal respiratory fistulae are abnormal communications between the esophagus and the respiratory system. They are either congenital or acquired. Most acquired esophageal respiratory fistulae are of the esophageal tracheal and esophageal bronchial type and are caused by infections or malignant neoplasms, whereas esophageal pulmonary fistulae are rare. CASE PRESENTATION: We report a case of a 72-year-old Caucasian man with squamous cell carcinoma of the lung presenting with abrupt-onset dyspnea during localized mediastinal radiotherapy...
May 2, 2018: Journal of Medical Case Reports
Erik Folch, Colleen Keyes
Stents and tubes to maintain the patency of the airways are commonly used for malignant obstruction and are occasionally employed in benign disease. Malignant airway obstruction usually results from direct involvement of bronchogenic carcinoma, or by extension of carcinomas occurring in the esophagus or the thyroid. External compression from lymph nodes or metastatic disease from other organs can also cause central airway obstruction. Most malignant airway lesions are surgically inoperable due to advanced disease stage and require multimodality palliation, including stent placement...
March 2018: Annals of Cardiothoracic Surgery
ZhongLi Liao, GuoBin Liao, Xin Yang, Xue Peng, Xia Zhang, Xia Xie, XiaoYan Zhao, ShiMing Yang, ChaoQiang Fan, JianYing Bai
BACKGROUND AND AIMS: Esophageal stricture is a common adverse event after endoscopic submucosal dissection (ESD) when it involves the entire circumference of the esophagus. We aimed to assess the effectiveness and safety of endoscopic transplantation of autologous esophageal mucosa in preventing stricture formation after circumferential ESD. METHODS: Nine patients who underwent circumferential ESD for early esophageal cancer were enrolled. After the patients underwent ESD, autologous esophageal mucosal patches were attached to the ulcer surface by using hemoclips and were then fixed with a covered metal mesh stent...
September 2018: Gastrointestinal Endoscopy
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