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Oesophagectomy

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https://www.readbyqxmd.com/read/29319022/thoracoscopic-oesophagectomy-for-end-stage-achalasia
#1
Vaibhav Kumar Varshney, Subhash Chandra Soni, Manju Kumari, Pawan Kumar Garg, Ashok Puranik
Achalasia cardia is an oesophageal motility disorder characterised by aperistalsis and failure of relaxation of the lower oesophageal sphincter. The management is predominantly palliative with focus on addressing the sphincter that involves either pneumatic dilatation or Heller myotomy which relieves dysphagia in the majority of the cases. End-stage achalasia (ESA) is characterised by failed myotomy, massively dilated and tortuous oesophagus with nutritional deterioration due to progressive dysphagia and vomiting...
January 10, 2018: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/29259274/gastrectomy-compared-to-oesophagectomy-for-siewert-ii-and-iii-gastro-oesophageal-junctional-cancer-in-relation-to-resection-margins-lymphadenectomy-and-survival
#2
Joonas H Kauppila, Karl Wahlin, Jesper Lagergren
It is unclear whether gastrectomy or oesophagectomy offer better outcomes for gastro-oesophageal junction (GOJ) cancer. A total of 240 patients undergoing total gastrectomy (n = 85) or oesophagectomy (n = 155) for Siewert II-III GOJ adenocarcinoma were identified from a Swedish prospective population-based nationwide cohort. The surgical approaches were compared in relation to non-radical resection margins (main outcome) using multivariable logistic regression, providing odds ratios (ORs) and 95% confidence intervals (CIs), mean number of removed lymph nodes with standard deviation (SD) using ANCOVA, assessing mean differences and 95% CIs, and 5-year mortality using Cox regression estimating hazard ratios (HRs) and 95% CIs...
December 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29244113/t1n0-oesophageal-cancer-patterns-of-care-and-outcomes-over-25-years
#3
Mohamed K Kamel, Benjamin Lee, Mohamed Rahouma, Sebron Harrison, Andrew B Nguyen, Jeffrey L Port, Nasser K Altorki, Brendon M Stiles
OBJECTIVES: Historically, surgical resection has been the mainstay of treatment for T1N0 oesophageal cancer (OC). More recently, oesophageal sparing endoscopic techniques have shown value for local control in a large institutional series. However, the effect of their utilization upon survival rates in large population series is largely unknown. METHODS: The surveillance, epidemiology, and end results (SEER) database was queried for T1N0M0-OC patients (1988-2013)...
December 13, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29182001/surgical-resection-of-a-massive-primary-mediastinal-liposarcoma-with-cervical-extension
#4
H L Weaver, S D Preston, H H Wong, P Jani, A S Coonar
A 73-year-old man was referred for surgical excision of a massive mediastinal and cervical liposarcoma following neoadjuvant chemotherapy. Surgery was performed via a cervical incision, sternotomy and right posterolateral thoracotomy. The tumour arose from the oesophagus, which underwent extensive dissection and was oversewn with pleura after tumour resection. Histology confirmed a completely excised grade 2 de-differentiated liposarcoma with complete macroscopic excision. The patient made an excellent recovery...
November 28, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/29177502/prognostic-value-of-lymph-node-count-on-survival-in-pathologically-node-negative-oesophageal-squamous-cell-cancer
#5
Yue Yu, Wei Wang, Qing Li, Fei Zhao, Yue Zhou, Jing Xu, Chenjun Huang
OBJECTIVES: This study aims to determine whether lymph node (LN) count is an independent predictor of survival in patients with pathologically node-negative (pN0) oesophageal squamous cell carcinoma (OSCC). METHODS: Retrospective analysis was performed on 194 pN0 OSCC patients undergoing radical oesophagectomy between January 2004 and December 2008. The association between the LN count and survival was assessed using the Cox proportional hazard model. The optimal LN count cut-off values were determined using the X-tile program...
November 21, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29164294/a-novel-technique-of-paravertebral-thoracic-and-preperitoneal-analgesia-enhances-early-recovery-after-oesophagectomy
#6
Stephanie Phillips, Jasmina Dedic-Hagan, d'Arcy Ferris Baxter, H Van der Wall, G L Falk
BACKGROUND: Excellent analgesia following oesophagectomy facilitates patient comfort, early extubation, physiotherapy and mobilisation, reduces post-operative complications and should enhance recovery. Thoracic epidural analgesia (TEA), the gold standard analgesic regimen for this procedure, is often associated with systemic hypotension treated with inotropes or fluid. This may compromise enhanced recovery and be complicated by anastomotic ischaemia or tissue oedema. METHODS: We report a novel analgesic regimen to reduce post-operative inotrope usage...
November 21, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29160918/impact-of-weight-loss-and-eating-difficulties-on-health-related-quality-of-life-up-to-10%C3%A2-years-after-oesophagectomy-for-cancer
#7
P Anandavadivelan, A Wikman, A Johar, P Lagergren
BACKGROUND: Severe weight loss is experienced by patients with eating difficulties after surgery for oesophageal cancer. The aim of this prospective cohort study was to asssess the influence of eating difficulties and severe weight loss on health-related quality of life (HRQoL) up to 10 years after oesophagectomy. METHODS: Data on bodyweight and HRQoL were collected at 6 months, 3, 5 and 10 years in patients who underwent surgery for oesophageal cancer in Sweden between 2001 and 2005...
November 21, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/29125080/-organ-sparing-treatment-in-oesophagus-cancer-feasible-and-safe
#8
B J Noordman, B P L Wijnhoven, S M Lagarde, M C W Spaander, R Valkema, J J B van Lanschot
In many countries, neoadjuvant chemoradiotherapy (nCRT) plus surgery is standard treatment for resectable oesophageal cancer. After nCRT, up to 30% of all patients have no residual disease in the resection specimen. Consequently, an active surveillance approach, in which patients undergo frequent clinical investigations after nCRT instead of standard oesophagectomy, is increasingly applied in selected patients. Here, we describe outcomes for three patients who underwent active surveillance. A 63-year old woman was considered unfit for surgery after nCRT...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29105078/a-systematic-review-of-the-incidence-of-and-risk-factors-for-postoperative-atrial-fibrillation-following-general-surgery
#9
REVIEW
R Chebbout, E G Heywood, T M Drake, J R L Wild, J Lee, M Wilson, M J Lee
Atrial fibrillation is a common cardiac arrhythmia and can occur de novo following a surgical procedure. It is associated with increased inpatient and long-term mortality. There is limited evidence concerning new-onset atrial fibrillation following abdominal surgery. This study aimed to identify the prevalence of and risk factors for postoperative atrial fibrillation in the general surgical population. A systematic search of the Embase, MEDLINE and Cochrane (CENTRAL) databases was conducted. Studies were included in the review if they reported cases of new-onset atrial fibrillation within 30 days of the index operation...
November 4, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29054892/transthoracic-littre-s-hernia-presenting-with-faecopneumothorax-following-perforation-of-the-meckel-s-diverticulum-a-late-complication-of-oesophagectomy
#10
Charles West, Karen Erskine, Khaled Hamdan
A Littre's hernia is an unusual phenomenon where a Meckel's diverticulum protrudes through a potential abdominal opening. We wish to present a unique case of a 79-year-old man with respiratory distress following a fall from standing, initially managed as a haemothorax. After a chest drain was placed, bowel contents were drained from the pleural cavity and he was taken to theatre. He had a history of minimally invasive oesophagectomy for cancer and had subsequently developed a diaphragmatic hernia. A blind ending diverticulum with a perforation at its tip was found in the left oblique lung fissure that was subsequently confirmed histologically as a perforated Meckel's diverticulum...
October 20, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29034090/pre-to-postoperative-coagulation-profile-of-307-patients-undergoing-oesophageal-resection-with-epidural-blockade-over-a-10-year-period-in-a-single-hospital-implications-for-the-risk-of-spinal-haematoma
#11
Owain Thomas, Emanuel Lybeck, Per Flisberg, Ulf Schött
BACKGROUND: Epidural anaesthesia and analgesia are indicated for oesophageal surgery. A rare but serious complication is spinal haematoma, which can occur on insertion, manipulation or withdrawal of catheters. Evidence and guidelines are vague regarding which tests are appropriate and how to interpret their results. We aimed to describe how routine coagulation test results change during oesophagectomy's perioperative course. METHODS: Following ethical approval, we retrospectively identified patients who had undergone oesophagectomy between 2002 and 2012...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/29033395/perioperative-changes-in-exhaled-nitric-oxide-during-oesophagectomy
#12
Piers Boshier, Alison Knaggs, George B Hanna, Nandor Marczin
Introduction Oesophagectomy is a major surgical procedure, associated with high rates of postoperative cardiopulmonary morbidity, that is in part due to the frequent requirement for periods of intraoperative one lung ventilation (OLV). The current pilot study aims to investigate variation in exhaled NO levels during oesophagectomy with emphasis on the response to OLV and correlation to physiological variables and clinical outcomes. Methods Breath-to-breath concentrations of NO were analysed in patients undergoing oesophagectomy at various stages of two lung ventilation...
October 16, 2017: Journal of Breath Research
https://www.readbyqxmd.com/read/29032792/centralisation-of-oesophagectomy-in-australia-is-only-caseload-critical
#13
Richard Hummel, Ngoc Hoang Ha, Andrew Lord, Markus I Trochsler, Guy Maddern, Harsh Kanhere
Objective High caseload is considered one of the most important factors for good outcomes after high-risk surgeries such as oesophagectomy. However, many Australian centres perform low volumes of oesophagectomies due to demographics. The aim of the present study was to audit outcome after oesophagectomy in an Australian low-volume centre over a period of 13 years and to discuss potential contributors to outcome other than just case volume.Methods Perioperative and long-term outcomes of all oesophagectomies over a 13-year period in a low-volume Australian tertiary care centre were analysed retrospectively...
October 16, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/29029018/corrigendum-to-chewing-50-times-per-bite-could-help-to-resume-oral-feeding-on-the-first-postoperative-day-following-minimally-invasive-oesophagectomy-eur-j-cardiothorac-surg-2017
#14
Zhengshuai Zhu, Yin Li, Yan Zheng, Haibo Sun, Xianben Liu, Ruixiang Zhang, Zongfei Wang, Shilei Liu, Xiankai Chen, Xionghuai Hua, Yongkui Yu, Haomiao Li, Jun Zhang, Qi Liu
No abstract text is available yet for this article.
October 4, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28983904/pre-operative-variables-including-fitness-associated-with-complications-after-oesophagectomy
#15
R C F Sinclair, A W Phillips, M Navidi, S M Griffin, C P Snowden
Oesophagectomy is a technically-demanding operation associated with a high level of morbidity. We analysed the association of pre-operative variables, including those from cardiopulmonary exercise testing, with complications (logistic regression) and survival and length of stay (Cox regression) after scheduled transthoracic oesophagectomy in 273 adults, in isolation and on multivariate testing (maximum Akaike information criterion). On multivariate analysis, any postoperative complication was associated with ventilatory equivalents for carbon dioxide, odds ratio (95%CI) 1...
October 5, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28982887/chemoradiotherapy-for-solitary-skeletal-muscle-metastasis-from-oesophageal-cancer-case-report-and-brief-literature-review
#16
REVIEW
Yoshiaki Fujimoto, Yuichiro Nakashima, Shun Sasaki, Tomoko Jogo, Kosuke Hirose, Keitaro Edahiro, Shotaro Korehisa, Daisuke Taniguchi, Kensuke Kudou, Y U Nakaji, Ryota Nakanishi, Koji Ando, Hiroshi Saeki, Eiji Oki, Minako Fujiwara, Yoshinao Oda, Yoshihiko Maehara
BACKGROUND: The incidence of skeletal muscle metastasis from oesophageal cancer is very low, and the treatment strategy has not been established. CASE REPORT: A 77-year-old man underwent oesophagectomy following neoadjuvant chemotherapy for oesophageal squamous cell carcinoma (CT-pT3 N0 M0, CT-pStage II). Fourteen months after surgery, he became aware of a subcutaneous tumour in his left forearm. Computed tomography and fluorodeoxyglucose positron-emission tomography revealed a 65×75 mm intramuscular nodular lesion with a standardized uptake value of 8...
October 2017: Anticancer Research
https://www.readbyqxmd.com/read/28958030/chewing-50-times-per-bite-could-help-to-resume-oral-feeding-on-the-first-postoperative-day-following-minimally-invasive-oesophagectomy
#17
Zhengshuai Zhu, Yin Li, Yan Zheng, Haibo Sun, Xianben Liu, Ruixiang Zhang, Zongfei Wang, Shilei Liu, Xiankai Chen, Xionghuai Hua, Yongkui Yu, Haomiao Li, Jun Zhang, Qi Liu
OBJECTIVES: In our previous study, early oral feeding following McKeown minimally invasive oesophagectomy (MIE) has been shown to be a safe and a feasible approach for early recovery of intestinal function and an improvement of quality of life. This study investigates the effect of 'chewing 50 times per bite' on early oral feeding following MIE. METHODS: Between May 2016 and December 2016, we retrospectively analysed 95 cases of oesophageal carcinoma in patients who underwent MIE in our department...
August 23, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28950364/extracorporeal-membrane-oxygenation-to-facilitate-tracheal-healing-after-oesophagogastric-catastrophe
#18
Eric I Jeng, Giovanni Piovesana, Jeremy Taylor, Tiago N Machuca
Anastomotic leak after oesophagectomy is associated with poor outcomes. We report the successful utilization of venovenous extracorporeal membrane oxygenation in conjunction with tracheal stent to treat and heal multiple tracheal-neo-oesophageal fistulae following oesophagectomy.
August 7, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28884329/perioperative-mortality-following-oesophagectomy-and-pancreaticoduodenectomy-in-australia
#19
Sean S Davis, Wendy J Babidge, Andreas Kiermeier, R James Aitken, Guy J Maddern
INTRODUCTION: Oesophagectomy (OG) and pancreaticoduodenectomy (PD) remain associated with significant perioperative mortality rates (POMR). Improved outcomes in high-volume centres have led to these procedures being centralised in some countries. This retrospective, population-based cohort study was conducted to determine the Australian national, and state and territory based POMR associated with OG and PD, and assess trends over time. METHODS: Logistic regression analysis was performed using de-identified procedural data between 1 July 2005 and 30 June 2013 from the Australian Institute of Health and Welfare...
September 7, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28815074/enhanced-recovery-protocols-after-oesophagectomy
#20
REVIEW
Laura J Halliday, Sheraz R Markar, Sophie L F Doran, Krishna Moorthy
The feasibility and safety of enhanced recovery protocols (ERP) have been demonstrated in a large number of surgical specialties. Several studies have shown improved post-operative outcomes and economic benefit from the use of ERPs in oesophageal cancer surgery. However, these improvements are not always translated more widely into clinical practice due to variation in protocols, poor compliance and failure to implement a robust implementation strategy. ERP implementation strategies should reflect the fact that these are complex interventions that are influenced by a wide range of social, organizational and cultural factors...
July 2017: Journal of Thoracic Disease
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