Distal-end esophagostomy of the excluded esophagus in the palliation of upper and mid-esophageal carcinoma

Article Abstract:

It is especially difficult to treat carcinoma (a type of malignant tumor) of the upper and middle region of the esophagus, the muscular canal which extends from the throat to the stomach. Serious nutritional and breathing problems, and poor long-term survival are associated with esophageal carcinoma. Successful removal of these tumors is difficult to achieve. A surgical technique for excluding the inoperable portion of the diseased esophagus from function and bypassing the stomach was developed according to three principles: re-establishing continuity of the digestive tract without multiple procedures; minimal interference with respiration; and a minimal number of closely placed suture lines in the esophagus. When first introduced in 1975 this procedure provided palliative treatment for patients with inoperable esophageal tumors; the tumor and the esophagus were left in place and the tumor could be treated with radiation therapy or chemotherapy. However, there was a high rate of dehiscence, or separation, of the sutures at the end of the excluded esophagus (which was not functioning in the passage of food). This caused material from the tumor to leak into the body and led to abscess formation, sepsis and, in some cases, death. A new technique is presented; it involves separating the portion of the esophagus with an inoperable tumor and attaching the end of it to a surgically created opening in the right side of the back. This minimizes the chance of tumor-related drainage leaking into a body cavity, and reduces the risk of abscess formation and infection. The upper end of the esophagus (at the throat) is attached to the stomach, which is pulled up under the skin to lie outside of the sternum, or breastbone. Patients can continue to receive oral nutrition. Six patients with advanced esophageal carcinoma in the upper or middle region of the esophagus underwent the revised procedure, known as a distal-end esophagostomy. One of the six patients did develop drainage, but it did not cause a life-threatening situation. (Consumer Summary produced by Reliance Medical Information, Inc.)

Surgery, Palliative care, Cancer, Cancer treatment, Esophageal cancer, Esophageal surgery

---

Management of huge epiphrenic esophageal diverticula

Article Abstract:

Outpouchings of the esophagus (diverticula) above the diaphragm often occur at the same time as disorders affecting the muscles of the lower portion of the esophagus. Four patients afflicted with huge diverticula of the esophagus were studied to determine the need for complete x-ray and pressure (manometric) studies of the esophagus before surgical treatment. Each of these patients was treated surgically either by removal of the diverticula, or by cutting muscles of the esophageal wall. One patient developed an inability to swallow because of a muscular constriction of the esophagus which required a dilation procedure. The authors believe that it is essential that these patients be treated with a muscle cutting procedure (esophagomyotomy) as part of the initial surgery.

Esophageal diverticulum

---

Esophageal and jejunal motor function after total gastrectomy and Roux-Y esophagojejunostomy

Article Abstract:

This study examines the level of movement resulting in emptying ingested material through the esophagus and the middle portion (jejunum) of the small intestine in patients who have had their stomach removed surgically and have had a particular class of reconstruction, Roux-Y loop. This group of 11 patients was examined by x-ray. Impairment of the esophagus was found in five patients, who were all at least 50 years old. The results were compared to results from a study of a similarly aged group of seven healthy subjects, five of whom had normal esophageal functions. Five patients in the first group complained of various gut symptoms, but these complaints could not be correlated with the laboratory findings.

Complications and side effects, Medical examination, Gastrointestinal system, Intestine, Small, Small intestine, Gastrointestinal motility, Gastrectomy

Similar abstracts:

• Abstracts: Delayed delivery of multiple gestations: maternal and neonatal outcomes. Patient perceptions of multiple gestations: an assessment of knowledge and risk aversion
• Abstracts: Efficacy of neonatal ocular prophylaxis for the prevention of chlamydial and gonococcal conjunctivitis. Why we need a program for the control of Chlamydia trachomatis
• Abstracts: Community outbreaks of asthma associated with inhalation of soybean dust. Chikungunya outbreaks--The globalization of vectorborne diseases
• Abstracts: The effects of cimetidine on the oxidative metabolism of estradiol. Male hypogonadism with gynecomastia caused by late-onset deficiency of testicular 17-ketosteroid reductase
• Abstracts: Appendicitis in children aged 13 years and younger. Treatment of rectal carcinoid tumors. The consequences of current constraints on surgical treatment of appendicitis

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.