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Oesophagectomy

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https://www.readbyqxmd.com/read/29761518/the-value-of-inflammation-based-prognostic-scores-in-patients-undergoing-surgical-resection-for-oesophageal-and-gastric-carcinoma
#1
Jiaxin Wen, Matthew Bedford, Ruksana Begum, Harriet Mitchell, James Hodson, John Whiting, Ewen Griffiths
BACKGROUND AND OBJECTIVES: Surgical interventions for oesophagogastric cancer carry a significant burden of morbidity and mortality. A range of inflammation based prognostic scores have been proposed in an attempt to predict outcome. This study evaluated five such prognostic scores in oesophageal and gastric carcinoma patients. METHODS: The modified Glasgow Prognostic Score (mGPS), Neutrophil Lymphocyte Ratio (NLR), Platelet Lymphocyte Ratio (PLR), Prognostic Index (PI), and Prognostic Nutrition Index (PNI) were calculated for 723 consecutive patients undergoing oesophagectomy or gastrectomy at a single center...
May 14, 2018: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29746653/is-surgical-apgar-score-an-effective-assessment-tool-for-the-prediction-of-postoperative-complications-in-patients-undergoing-oesophagectomy
#2
Shuangjiang Li, Kun Zhou, Pengfei Li, Guowei Che
A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was whether the surgical Apgar score (SAS) was an effective assessment tool for the prediction of postoperative complications in patients undergoing oesophagectomy. In total, 7 papers were identified using the reported search, of which 6 cohort studies represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated...
May 9, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29737322/robotic-assisted-minimally-invasive-oesophagectomy-for-cancer-an-initial-experience
#3
Chinnusamy Palanivelu, Sumanta Dey, Sandeep Sabnis, Raghavendra Gupta, Bharath Cumar, Saravana Kumar, Ramesh Natarajan, Parthasarathi Ramakrishnan
Background: The morbidity related to radical oesophagectomy can be reduced by adopting minimally invasive techniques. Over 250 thoraco-laparoscopic oesophagectomy (TLE) was done in our centre over the last 15 years, before adopting robotic surgery as the latest innovation in the field of minimally invasive surgery. Here, we share our initial experience of robotic-assisted minimally invasive oesophagectomy (RAMIE) for carcinoma oesophagus. Methods: A prospective observational study conducted from February to December 2017...
May 4, 2018: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/29718251/major-complications-of-minimally-invasive-ivor-lewis-oesophagectomy-using-the-purse-string-stapled-anastomotic-technique-in-215-patients-with-oesophageal-carcinoma
#4
Ningning Kang, Renquan Zhang, Wei Ge, Panpan Si, Menglong Jiang, Yunlong Huang, Yanxin Fang, Long Yao, Kaiming Wu
OBJECTIVES: The purse string-stapled anastomotic technique is a method for minimally invasive oesophagectomy with intrathoracic anastomosis, in which a purse string is hand sewn without the necessity of specialized devices, such as OrVil and Endo-Stitch. Since this technique was first reported by our surgical team in 2012, several measures in the operation have been refined. Furthermore, there are very few literature reports on the major complications of minimally invasive oesophagectomy with this technique...
April 27, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29667092/intraoperative-pyloric-interventions-during-oesophagectomy-a-multicentre-study
#5
Salvatore Marchese, Yassar A Qureshi, Shazia P Hafiz, Khaled Dawas, Paul Turner, M Muntzer Mughal, Borzoueh Mohammadi
BACKGROUND: Denervation of the pylorus after oesophagectomy is considered the principal factor responsible for delayed gastric emptying. Several studies have attempted to delineate whether surgical or chemical management of the pylorus during oesophagectomy is of benefit, but with conflicting results. The aim of this multicentre study was to assess whether there was any difference in outcomes between different approaches to management of the pylorus. METHODS: A prospectively maintained database was used to identify patients who underwent oesophagectomy for malignancy...
April 17, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29648637/medium-and-long-term-emergency-department-utilization-after-oesophagectomy-a-population-based-analysis
#6
Biniam Kidane, Binu Jacob, Vaibhav Gupta, John Peel, Refik Saskin, Thomas K Waddell, Gail E Darling
OBJECTIVES: Oesophagectomy is a complex operation with the potential for prolonged recovery. The aim of this study was to evaluate healthcare resource utilization, specifically emergency department (ED) visits within 1 year of oesophagectomy, and to identify risk factors for ED visits and frequent ED use (FEDU). METHODS: A retrospective cohort study of consecutive oesophagectomies for cancer in all Ontario hospitals was conducted using linked health data (2000-2012) including the ability to identify ED visits at non-index hospitals...
April 10, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29609046/a-novel-technique-for-cervical-gastro-oesophageal-anastomosis-during-minimally-invasive-oesophagectomy
#7
Zhi-Qiang Wang, Yue-Quan Jiang, Wei Xu, Hua-Rong Cai, Zhi Zhang, Zhe Yin, Qi Zhang
BACKGROUND: Anastomotic leakage, fibrous stricture and gastro-oesophageal reflux are three major complications of gastro-oesophageal anastomosis, particularly in cervical anastomosis. Our aim was to evaluate the safety and efficacy of a novel cervical anastomosis technique (NA) by comparing it to traditional side-to-side anastomosis (SS) and end-to-side anastomosis using a circular stapler (CS) in terms of postoperative leakage, stricture and reflux. METHODS: A total of 390 patients with thoracic oesophageal cancer underwent minimally invasive oesophagectomy with cervical anastomosis (192 with NA, 34 with SS and 164 with CS) in our institute from January 2013 and May 2016...
March 30, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29603130/multicentre-randomized-clinical-trial-of-inspiratory-muscle-training-versus-usual-care-before-surgery-for-oesophageal-cancer
#8
K Valkenet, J C A Trappenburg, J P Ruurda, E M Guinan, J V Reynolds, P Nafteux, M Fontaine, H E Rodrigo, D L van der Peet, S W Hania, M N Sosef, J Willms, C Rosman, H Pieters, J J G Scheepers, T Faber, E A Kouwenhoven, M Tinselboer, J Räsänen, H Ryynänen, R Gosselink, R van Hillegersberg, F J G Backx
BACKGROUND: Up to 40 per cent of patients undergoing oesophagectomy develop pneumonia. The aim of this study was to assess whether preoperative inspiratory muscle training (IMT) reduces the rate of pneumonia after oesophagectomy. METHODS: Patients with oesophageal cancer were randomized to a home-based IMT programme before surgery or usual care. IMT included the use of a flow-resistive inspiratory loading device, and patients were instructed to train twice a day at high intensity (more than 60 per cent of maximum inspiratory muscle strength) for 2 weeks or longer until surgery...
April 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29595182/c-reactive-protein-as-predictor-of-anastomotic-complications-after-minimally-invasive-oesophagectomy
#9
Vladimir Prochazka, Filip Marek, Lumir Kunovsky, Roman Svaton, Martina Farkasova, Martin Potrusil, Petr Moravcik, Zdenek Kala
BACKGROUND: Anastomotic leaks after oesophagectomy with tabularised stomach replacement are a significant factor in post-operative mortality and morbidity. Early detection and treatment of this complication allow for improving operative and oncological results. When assessing laboratory values - elevation of inflammatory parameters - complicated interpretation is an issue (systemic inflammatory response syndrome, surgical versus non-surgical complication). Results studying the relationship between C-reactive protein (CRP) and complications following oesophagectomies are inconsistent...
March 23, 2018: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/29582802/the-surgical-outcome-of-minimally-invasive-pharyngo-laryngo-oesophagectomy-in-prone-position
#10
Mariko Ogino, Yuma Ebihara, Akihiro Homma, Kimitaka Tanaka, Yoshitsugu Nakanishi, Toshimichi Asano, Takehiro Noji, Yo Kurashima, Soichi Murakami, Toru Nakamura, Takahiro Tsuchikawa, Keisuke Okamura, Toshiaki Shichinohe, Satoshi Hirano
PURPOSE: Pharyngo-laryngo-oesophagectomy (PLE) which is mainly indicated for cervical oesophageal cancer or synchronous double cancer of the thoracic oesophagus and the pharynx or larynx, is extremely invasive. Since minimally invasive oesophagectomy (MIE) using video-assisted thoracic surgery has become popular recently, the procedure can be adopted to PLE. Moreover, the use of the prone position (PP) in MIEs has been increasing recently because technical advantages and fewer post-operative complications were reported...
March 23, 2018: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/29555526/neoadjuvant-therapy-reduces-cardiopulmunary-function-in-patients-undegoing-oesophagectomy
#11
Iain G Thomson, Matthew P Wallen, Adrian Hall, Rebekah Ferris, David C Gotley, Andrew P Barbour, Andrew Lee, Janine Thomas, Bernard M Smithers
Neoadjuvant therapy (NAT) for oesophageal cancer may reduce cardiopulmonary function, assessed by cardiopulmonary exercise testing (CPEX). Impaired cardiopulmonary function is associated with mortality following esophagectomy. We sought to assess the impact of NAT on cardiopulmonary function using CPEX and assessing the clinical relevance of any change in particular if changes were associated with post-operative morbidity. This was a prospective, cohort study of 40 patients in whom CPEX was performed before and after NAT...
March 16, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29525470/management-of-peri-operative-anaemia-in-a-patient-with-rare-alloantibodies-scheduled-for-oesophagectomy
#12
E García, M P Blanco, S Riaño, I González-Mendibil, T Carrascosa, M T Antolín
A description is presented on the management of a patient with an oesophageal neoplasm scheduled for oesophagectomy. Alloantibodies were detected during a blood components reservation procedure, which made it almost impossible to obtain compatible blood. Peri-operative anaemia management or "Patient Blood Management" should be routinely performed in all patients at transfusion risk. This strategy has been considered as one of the actions to bear in mind in fast-track surgery or enhanced recovery after surgery...
March 7, 2018: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29520647/colonic-interposition-after-adult-oesophagectomy-systematic-review-and-meta-analysis-of-conduit-choice-and-outcome
#13
Jade Brown, Wyn G Lewis, Antonio Foliaki, Geoffrey W B Clark, Guy R J C Blackshaw, David S Y Chan
BACKGROUND: Colonic interposition is a second-line option after oesophagectomy when a gastric neo-oesophagus is not viable. There is no consensus on the optimum anatomical colonic conduit (right or left), or route of placement (posterior mediastinal, retrosternal or subcutaneous). The aim of this review was to determine the optimum site and route of neo-oesophageal conduit after adult oesophagectomy. METHODS: PubMed, MEDLINE, and the Cochrane Library (January 1985 to January 2017) were systematically searched for studies which reported outcomes following colonic interposition in adults...
March 8, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29509539/cervical-exenteration-guidelines-and-surgical-technique-principles
#14
Constantin Ciuce, Răzvan Scurtu, Cătălin Ciuce, Raluca Apostu, Horea Bocşe, George Dindelegan
Introduction: Neoplastic invasion of the structures of the cervical region originating from a malignant tumour developed in one of the viscera of the throat may benefit from cervical exenteration. Defined as resection of the hypopharynx, cervical oesophagus, larynx and cervical trachea, exenteration has limited indications and is mandatorily accompanied by digestive tube reconstruction. The aim of this article is to highlight the indication, surgical strategy and important surgical stages illustrated by images from personal professional experience...
January 2018: Chirurgia
https://www.readbyqxmd.com/read/29484166/successful-management-of-an-aorto-gastric-fistula-occurring-15-years-after-oesophagectomy-with-covered-aortic-stent-graft-placement-followed-by-open-surgery
#15
Heena S Chotai, Guy Finch, Davis Thomas, Gabor Libertiny
Aorto-gastric fistula (AGF) is an uncommon and life threatening complication of oesophagectomy. Usually occurring in the immediate weeks following the procedure at anastomosis lines, this case describes a rare development of an AGF 15 years after an oesophagectomy due to the presence of a benign ulcer. Initially successful endovascular stenting of the thoracic aorta was followed by re-bleed, further stenting but eventually open surgery was required.
February 2018: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29479417/the-role-of-tevar-in-the-management-of-a-recurrent-aorto-gastric-fistula
#16
Terri-Ann T Russell, Pranitha Pinnamaraju, Maher Hamish
An aorto-gastric fistula is a catastrophic and rare cause of an upper gastrointestinal bleed. The diagnosis requires a high index of suspicion and expedient management as any delay in each of these component, will be to the detriment of the patient. We report a case of a patient with two episodes of this rare event, with haemodynamic compromise, 15 years after having had a trans-hiatal oesophagectomy for an adenocarcinoma of the oesophagus who presented on both occasions. He had thoracic endo-vascular aortic repair (TEVAR) on both presentations and survived...
February 2018: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29465746/using-textbook-outcome-as-a-measure-of-quality-of-care-in-oesophagogastric-cancer-surgery
#17
R T van der Kaaij, M V de Rooij, F van Coevorden, F E M Voncken, P Snaebjornsson, H Boot, J W van Sandick
BACKGROUND: Textbook outcome is a multidimensional measure representing an ideal course after oesophagogastric cancer surgery. It comprises ten perioperative quality-of-care parameters and has been developed recently using population-based data. Its association with long-term outcome is unknown. The objectives of this study were to validate the clinical relevance of textbook outcome at a hospital level, and to assess its relation with long-term survival after treatment for oesophagogastric cancer...
April 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29460796/effects-of-goal-directed-fluid-therapy-on-enhanced-postoperative-recovery-an-interventional-comparative-observational-study-with-a-historical-control-group-on-oesophagectomy-combined-with-eras-program
#18
Hideki Taniguchi, Toshio Sasaki, Hisae Fujita, Hiroko Kobayashi, Rieko Kawasaki, Takashi Ogata, Haruhiko Cho, Takaki Yoshikawa, Keiko Ushigome, Akemi Tanaka, Osami Takano
BACKGROUND AND AIMS: The Enhanced Recovery after Surgery (ERAS) program has been proposed as a postoperative recovery-enhancing strategy. We frequently apply the Modified-ERAS program following oesophagectomy. This study aims to elucidate the impact of goal-directed fluid therapy (GDT) for the perioperative management of oesophageal cancer on the postoperative recovery of patients undergoing oesophagectomy. METHODS: This is an interventional before-after comparative observational study conducted at Kanagawa Cancer Centre, Japan...
February 2018: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/29451037/esophageal-hiatal-hernia-risk-diagnosis-and-management
#19
Hai-Xiang Yu, Chun-Shan Han, Jin-Ru Xue, Zhi-Feng Han, Hua Xin
Esophageal hiatal hernia involves abnormal abdominal entry into thoracic cavity. It is classified based on orientation between esophageal junction and diaphragm. Sliding hiatal hernia (Type-I) comprises the most frequent category, emanating from right crus of diaphragm. Type-II esophageal hernia engages both left and right muscular crura. Type-III and IV additionally include the left crus. Age and increased body mass index are key risk factors, and congenital skeletal aberrations trigger pathogenesis through intestinal malrotations...
April 2018: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29433991/changes-in-volume-clinical-practice-and-outcome-after-reorganisation-of-oesophago-gastric-cancer-care-in-england-a-longitudinal-observational-study
#20
M Varagunam, R Hardwick, S Riley, G Chadwick, D A Cromwell, O Groene
AIM: The centralisation of oesophago-gastric (O-G) cancer services in England was recommended in 2001, partly because of evidence for a volume-outcome effect for patients having surgery. This study investigated the changes in surgical services for O-G cancer and postoperative mortality since centralisation. METHODS: Patients with O-G cancer who had an oesophageal or gastric resection between April 2003 and March 2014 were identified in the national Hospital Episodes Statistics database...
April 2018: European Journal of Surgical Oncology
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