SciCombinator

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Concept: Esophagectomy

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We aimed to identify the presence and length of esophagectomy proficiency gain curves in terms of short- and long-term mortality for esophageal cancer.

Concepts: Obesity, Squamous cell carcinoma, Helicobacter pylori, Achalasia, Esophageal cancer, Esophagectomy, Nitrosamine

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: Survival and prognostic factors were analyzed in 315 patients with esophageal cancer undergoing thoracoscopic-assisted esophagectomy (TAE). The 5-year survival rate of 57.8% was satisfactory, indicating the oncological feasibility of TAE. Perioperative outcomes affected overall survival in the whole cohort but not in the subgroup treated with 2 endoscopic stages.

Concepts: Cancer staging, Medical terms, Obesity, Survival rate, Esophageal cancer, Five-year survival rate, Esophagectomy, Relative survival

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INTRODUCTION: The standard of care for achalasia is laparoscopic Heller’s cardiomyotomy. This procedure achieves satisfactory and long-standing results in over 85 % of patients. However, in 10-15 % of patients, esophageal function will progressively deteriorate, and up to 5 % will develop end-stage achalasia. Options in these difficult patients are limited, and include redo cardiomyotomy, repeat dilatation, and in severe cases, esophagectomy. METHODS: In this report, we describe an alternate approach, a cardioplasty, which was originally described by Heyrovsky in 1913. RESULTS: The development of an angulated stapling device now makes this operation feasible by a laparoscopic approach. CONCLUSION: This report highlights our technique for laparoscopic cardioplasty in patients with end-stage achalasia.

Concepts: Surgery, Staple, Achalasia, Esophageal cancer, Esophagectomy, Heller myotomy

8

Patients undergoing surgery for esophageal cancer have a high risk for postoperative deterioration of lung function and pulmonary complications. This is partly due to one-lung ventilation during thoracotomy. This often accounts for prolonged stay on intensive care units, delayed postoperative reconvalescence and reduced quality of life. Socioeconomic disadvantages can result from these problems. Physical preconditioning has become a crucial leverage to optimize fitness and lung function in patients scheduled for esophagectomy, in particular during the time period of neoadjuvant therapy.

Concepts: Cancer, Lung, Obesity, Squamous cell carcinoma, Achalasia, Esophageal cancer, Barrett's esophagus, Esophagectomy

4

To compare the outcome of per oral endoscopic myotomy (POEM) and laparoscopic Heller myotomy (LHM) for the treatment of esophageal achalasia.

Concepts: Surgery, Meta-analysis, Esophagogastroduodenoscopy, Achalasia, Esophageal cancer, Esophagectomy, Heller myotomy, Barium swallow

3

Restrictive intraoperative fluid management is increasingly recommended for patients undergoing esophagectomy. Controversy still exists about the impact of postoperative fluid management on perioperative outcome.

Concepts: Obesity, Retrospective, Squamous cell carcinoma, Helicobacter pylori, Achalasia, Esophageal cancer, Esophagectomy, Nitrosamine

3

The minimally invasive esophagectomy (MIE) is widely being implemented for esophageal cancer in order to reduce morbidity and improve quality of life. Non-randomized studies investigating the mid-term quality of life after MIE show conflicting results at 1-year follow-up. Therefore, the aim of this study is to determine whether MIE has a continuing better mid-term 1-year quality of life than open esophagectomy (OE) indicating both a faster recovery and less procedure-related symptoms.

Concepts: Obesity, Minimally invasive, Helicobacter pylori, Invasiveness of surgical procedures, Open surgery, Achalasia, Esophageal cancer, Esophagectomy

2

The preferred surgical approach for esophageal cancer is a minimally invasive transthoracic esophagectomy with a two-field lymph node dissection. The thoracoscopic phase may be performed either in prone- or in left lateral decubitus (LLD) position. Prone positioning has been associated with better pulmonary outcomes compared to LLD positioning; however, conversion to a classic thoracotomy is more difficult. The semiprone position has been proposed as an alternative approach.

Concepts: Lymph node, Obesity, Minimally invasive, Achalasia, Lymphadenectomy, Esophageal cancer, Esophagectomy, Prone position

2

The aim of this study was to investigate 3-year survival following a randomized controlled trial comparing minimally invasive with open esophagectomy in patients with esophageal cancer.

Concepts: Obesity, Randomized controlled trial, Minimally invasive, Helicobacter pylori, Open surgery, Achalasia, Esophageal cancer, Esophagectomy

2

Surgical resection is regarded as the only curative option for resectable oesophageal cancer, but pulmonary complications occurring in more than half of patients after open oesophagectomy are a great concern. We assessed whether minimally invasive oesophagectomy reduces morbidity compared with open oesophagectomy.

Concepts: Epidemiology, Randomized controlled trial, Minimally invasive, Resection, Invasive, Invasiveness of surgical procedures, Open surgery, Esophagectomy