• Title/Summary/Keyword: esophageal surgery

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A comparison of leak pressures between esophageal to esophageal anastomosis and esophageal to jejunal anastomosis

  • Cunningham, Devin P.;Middleton, John R.;Mann, F.A.
    • Korean Journal of Veterinary Research
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    • v.60 no.2
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    • pp.49-54
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    • 2020
  • The goal of this study was to determine if there was a difference in leak pressure between esophageal-esophageal anastomosis and esophageal-jejunal anastomosis when using cadaveric porcine tissue. Leak pressures were recorded for esophageal-esophageal anastomosis (Group 1 [control group], n = 7), cranial esophageal-jejunal anastomosis (Group 2, n = 7), and jejunal-caudal esophageal anastomosis (Group 3, n = 6). Each anastomosis was performed using polydioxanone sutures in a simple interrupted pattern. Results were analyzed using one-way analysis of variance. Mean ± SD of the leak pressures for groups 1, 2, and 3 were 46.1 ± 15.9, 36.5 ± 13.6, and 50.9 ± 11.1 mmHg, respectively (p = 0.18). When the results from groups 2 and 3 were combined and compared to that for Group 1, the mean ± SD leak pressures were 46.1± 15.9 and 43.1± 14.2 mmHg, respectively (p = 0.67). These results provide preliminary evidence that the jejunum may be a suitable option for use in esophageal replacement surgery; however, future studies of in vivo factors influencing the integrity of esophageal-jejunal anastomoses, including histologic evaluation of esophageal-jejunal anastomosis healing, are needed.

Reversed Gastric Tube Interposition in Esophageal Atresia (선천성 식도 폐쇄에서의 역위관 거치술)

  • Huh, Seung;Chun, Yong-Soon;Park, Kwi-Won;Kim, Woo-Ki
    • Advances in pediatric surgery
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    • v.1 no.2
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    • pp.162-169
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    • 1995
  • Since 1988, we have performed esophageal replacement with the reversed gastric tube on four esophageal atresia patients. Three patients had long-gap esophageal atresias and one patient had recurrent tracheoesophageal fistula that was previously operated on three times. One combined imperforate anus. The youngest patient was 6-month-old and the oldest, 34-month-old at the time of procedure. The technique of gastric tube construction is described. There have been both major and minor complications. Although two patients had shown distal tube strictures as late complications. those were solved with tuboplasties on 29 months and 48 months, postoperatively. Growth and development have been acceptable in all four patients, although most remain in the lower percentiles for growth and height, a condition that usually predates the esophageal substitution. Conclusively, reversed gastric tube interposition has proved very satisfactory for long-gap esophageal atresia that cannot be anastomosed primarily even by spiral myotomy and esophageal atresia with recurrent tracheoesophageal fistula having destroyed esophagus due to previous operation.

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Tracheal Compression by Esophageal Mucocele after Surgical Exclusion of the Esophagus - One case report- (식도격리수술 후 식도 점액류에 의한 기관압박 -1예 보고-)

  • Song In Hag;Lee Seung Jin;Park Hyung Joo;Lee Cheol Sae;Lee Kihl Rho;Lee Seock Yeol
    • Journal of Chest Surgery
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    • v.38 no.1 s.246
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    • pp.80-83
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    • 2005
  • A 43-year-old male was admitted to our hospital complaining of dyspnea and wheezing sound at respiration. He had received esophageal exclusion and esophagogastrostomy due to spontanous esophageal rupture 1-year ago. Chest computed tomography revealed esophageal mucocele like that of mediastinal tumor. Trachea is compressed by esophageal mucocele. The operation was performed by resection of thoracic esophagus through right open thoracotomy. Herein we report a case of a tracheal compression by esophageal mucocele after surgical exclusion of the esophagus.

Result of Secondary Surgery after Primary Surgery for Esophageal Atresia Anomalies (선천성 식도 폐쇄 수술 후 시행한 재 수술의 성적)

  • Im, Soo-Chan;Moon, Suk-Bae;Jung, Sung-Eun;Lee, Seong-Cheol;Park, Kwi-Won
    • Advances in pediatric surgery
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    • v.13 no.2
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    • pp.105-111
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    • 2007
  • We reviewed the records of 25 patients who were re-operated upon after primary repair of esophageal atresia with or without fistula at the Department of Pediatric Surgery, Seoul National University Children's Hospital, from January 1997 to March 2007. Types of the esophageal atresia anomalies were Gross type A in 5 patients, C in 18, and E in 2. The indications for re-operation were anastomosis stricture (n = 14), tracheo-bronchial remnant (n = 4), persistent anastomosis leakage (n = 3), recurrent tracheo-esophageal fistula (n = 2) and esophageal web (n = 2). The interval between primary and secondary surgery was from 48 days to 26 years 5 months (mean: 2 years and 4 months). Four patients required a third operation. The interval between the second and third operation was between 1 year 1 month and 3 year 10 month (mean: 2 years 5 months). Mean follow up period after last operation was 35 months (1 years-8 years 6 months). The secondary surgery was end-to-end esophageal anastomosis in 15, esophagoplasty in 5, gastric tube replacement in 5. After secondary operation, 6 patients had anastomosis stricture (4 patients were relieved of the symptoms by balloon dilatation, 2 patients underwent tertiary operation). Five patients had leakage (sealed on conservative management in all). Two patients had recurrent tracheo-esophagel fistula (1 patient received chemical cauterization and 1 patient underwent tertiary operation). Currently, only one patient has feeding problems. There were no mortalities. Secondary esophageal surgery after primary surgery for esophageal atresia was effective and safe, should be positively considered when complications do not respond to nonoperative therapy.

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Secondary Esophageal Reconstruction for Esophageal Atresia (식도 폐쇄증 환자에서 치험한 2차 식도 재건술)

  • Sa, Young-Jo;Park, Jae-Kil;Jeon, Hae-Myung;Moon, Young-Kyu;Sim, Sung-Bo;Lee, Sun-Hee
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.671-674
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    • 2008
  • Jejunum and fasciocutaneous and myocutaneous flaps are theoretically recommended as esophageal substitutes in reconstruction of the esophagus after several occurrences of failed reconstruction. However, other esophageal substitutes should also be considered. Secondary esophageal reconstruction was successfully performed on a 24-year-old woman who had a history of cervical, thoracic, and abdominal operations and esophageal stricture secondary to several failed reconstructions for esophageal atresia and tracheo-esophageal fistula 21 years prior. The esophageal reconstruction was done subcutaneously by end-to-side anastomosis at the left cervical area using a deformed stomach graft. The patient was discharged with the ability to consume a regular diet after the operation.

Congenital Esophageal Atresia Associated with a Tracheobronchial Remnant

  • Wu, Yuhao;Wu, Chun
    • Journal of Chest Surgery
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    • v.52 no.3
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    • pp.170-173
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    • 2019
  • A rare case of esophageal atresia/tracheo-esophageal fistula (EA-TEF) with an associated tracheobronchial remnant (TBR) is reported and discussed herein. A 13-month-old patient was seen with a complaint of vomiting of solid food 1 year after EA-TEF repair. An esophagogram showed a tapered narrowing in the lower segment of the esophagus. A re-operation was carried out and a pathologic examination of the resected stenotic segment revealed the presence of a TBR.

Minimally Invasive Approach to Esophageal Perforation after Endoscopic Ultrasound-Guided Fine-Needle Aspiration: A Report of 2 Cases

  • Geraedts, Anna C.M.;Broos, Pieter P.H.L.;Gronenschild, Michiel H.M.;Custers, Frank L.J.;Hulsewe, Karel W.E.;Vissers, Yvonne L.J.;de Loos, Erik R.
    • Journal of Chest Surgery
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    • v.53 no.5
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    • pp.313-316
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    • 2020
  • Esophageal perforation after endoscopic ultrasound-guided fine-needle aspiration for mediastinal staging is a rare but severe complication. We report 2 cases of patients with esophageal perforation who were treated using video-assisted thoracoscopic surgery in combination with esophageal stenting. Through these cases, the feasibility of minimally invasive thoracic surgery was evaluated.

Esophageal Cancer in Korea: Epidemiology and Treatment Patterns

  • Park, Seong Yong;Kim, Dae Joon
    • Journal of Chest Surgery
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    • v.54 no.6
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    • pp.454-459
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    • 2021
  • According to statistics from 2017, esophageal cancer is the fifteenth most common cancer and the eleventh most common cause of cancer-related death in Korea. The most common pathology is esophageal squamous cell carcinoma. Moreover, the incidence of esophageal cancer has been gradually decreasing in Korea, and the percentage of early-stage cases has gradually increased to the point that it is higher than that of other countries. The 5-year relative survival rate has improved over time. Approximately 800 esophagectomy procedures are performed annually. Using a cut-off number of 21 cases per 2 years to define high-volume centers, it was found that 70% of esophagectomies were performed by a few high-volume centers. Unfortunately, there is no nationwide registry or database on esophageal cancer and esophagectomy in Korea. Efforts to establish a nationwide database on esophageal cancer and esophagectomy should be made.

Esophageal Cancer Staging

  • Rice, Thomas W.
    • Journal of Chest Surgery
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    • v.48 no.3
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    • pp.157-163
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    • 2015
  • Accurate staging of esophageal cancer is very important to achieving optimal treatment outcomes. The AJCC (American Joint Committee on Cancer) first published TNM esophageal cancer staging recommendations in the first edition of their staging manual in 1977. Thereafter, the staging of esophageal cancer was changed many times over the years. This article reviews the current status of staging of esophageal cancer.

Expression of PGDH Correlates with Cell Growth in Both Esophageal Squamous Cell Carcinoma and Adenocarcinoma

  • Yang, Guo-Tao;Wang, Juan;Xu, Tong-Zhen;Sun, Xue-Fei;Luan, Zi-Ying
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.3
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    • pp.997-1000
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    • 2015
  • Esophageal cancer represents the fourth most common gastrointestinal cancer and generally confers a poor prognosis. Prostaglandin-producing cyclo-oxygenase has been implicated in the pathogenesis of esophageal cancer growth. Here we report that prostaglandin dehydrogenase, the major enzyme responsible for prostaglandin degradation, is significantly reduced in expression in esophageal cancer in comparison to normal esophageal tissue. Reconstitution of PGDH expression in esophageal cancer cells suppresses cancer cell growth, at least in part through preventing cell proliferation and promoting cell apoptosis. The tumor suppressive role of PGDH applies equally to both squamous cell carcinoma and adenocarcinoma, which enriches our understanding of the pathogenesis of esophageal cancer and may provide an important therapeutic target.