196,119 research outputs found
Esophagobronchial fistula after thoracoscopic resection of an epiphrenic diverticulum
No full textWe report a case of a 54-year-old man presenting with recurrent epiphrenic diverticulum and esophagobronchial fistula 3 years after thoracoscopic diverticulectomy. Surgical correction required transhiatal stapling of the pouch combined with distal esophageal myotomy and Dor fundoplication
Esophageal function studies in the management of gastroesophageal reflux disease
No full textEsophageal function testing, i.e. esophageal manometry and 24-h pH monitoring, are usually carried out to diagnose gastroesophageal reflux disease (GERD) in patients with atypical symptoms, when there is no evidence of esophagitis at endoscopy, or following previous unsuccessful surgery. Additionally, these studies should be considered mandatory before surgery to confirm the diagnosis and to tailor the procedure to the motility pattern of the individual patient
Heartburn and multiple-site foregut perforations as primary manifestation of Crohn's disease
No full textCrohn's disease may affect any segment of the digestive tract, more commonly the distal ileum, colon and/or perianal region. There is an increasing number of reports dealing with foregut Crohn's disease. We present the case of a patient with a history of heartburn and multiple spontaneous perforations of the esophagus, duodenum and jejunum as a primary manifestation of Crohn's disease who required emergency surgical and endoscopic procedures. Early detection of Crohn's disease may decrease the incidence of acute life-threatening complications provided that appropriate medical treatment is administered and a multidisciplinary approach is offered to these patients
The role of hepatic metastases and pulmonary tumor burden in predicting survival after complete pulmonary resection for colorectal cancer
No full textObjectiveOur objective was to investigate the role of clinicopathologic factors as predictors of outcome after complete pulmonary resection for metastatic colorectal cancer.MethodsConsecutive patients undergoing radical pulmonary resection for colorectal cancer at our institution were included in the study. Clinicopathologic variables including sex, age, site and stage of the primary tumor, disease-free interval, prior hepatic resection, timing of pulmonary metastases, preoperative chemotherapy, type of pulmonary resection, number, size, and location of pulmonary metastases, and thoracic lymph node involvement were retrospectively collected and investigated for prognostic significance. Survival curves were generated by the Kaplan-Meier technique and difference between factors were evaluated by the log–rank test.ResultsA total of 127 patients undergoing pulmonary resection between 1997 and 2009 were included in the study. The median follow-up was 67.1 months. The median overall survival from the time of pulmonary resection was 48.9 months. The 5-year overall survival was 45.4%. Among all investigated prognostic variables, the number of pulmonary metastases (1 vs >1) was the most important factor affecting the outcome after pulmonary resection (5-year overall survival 55.4% vs 32.2%; hazard rate, 1.92; P = .006).ConclusionsIn this study, the presence of a single pulmonary metastasis was a favorable predictor of survival after complete pulmonary resection for metastatic colorectal cancer. All the other prognostic variables did not seem to affect survival and should not contraindicate such surgery in clinical practice. However, the study sample size does not allow us to draw any definitive conclusion, and further investigation of the role of these prognostic factors in larger series is warranted
Does previous endoscopic treatment affect the outcome of laparoscopic Heller myotomy?
No full textAim of this study was to assess symptomatic and objective outcome in patients undergoing laparoscopic Heller myotomy after unsuccessful endoscopic treatment, compared to patients having primary surgery
Previous endoscopic treatment does not affect complication rate and outcome of laparoscopic Heller myotomy and anterior fundoplication for oesophageal achalasia
No full textAnedoctal reports suggest a detrimental effect of pneumatic dilation and botulinum toxin injection in patients who are potential candidates for Heller myotomy
Primary pulmonary meningioma: report of a case and review of the literature
No full textPrimary pulmonary meningioma (PPM) is a rare disease and usually presents as a solitary pulmonary nodule (SPN). These lesions are mostly benign, but malignant PPMs have been reported, and primary lung cancer or metastasis may be suspected on imaging. We report one case of benign PPM, with a review of 37 cases published in the literature. Diagnostic work-up included radiological chest study and in 3 cases positron emission tomography (PET) showing increased uptake, highly suspicious for malignancy. After exclusion of 13 cases lacking radiological studies of the central nervous system (CNS), 25 patients with radiological data and histological assessment confirming PPM were considered in the analysis. All patients underwent surgical resection except for 1 case with diagnosis at autopsy. Histological assessment revealed benign PPMs in 23 cases (including all 3 cases with positive PET) and malignant PPMs in 2 cases. No recurrence was observed in long-term follow-up of patients with benign PPMs, but the two malignant PPMs relapsed. PPM is an uncommon SPN, so that it can be misdiagnosed and its management unsuited. Indeed, 8 patients (32%) were overtreated with major thoracic surgical resection or with chemotherapy. When feasible, pulmonary wedge resection by video-assisted thoracic surgery (VATS) including intra-operative histological examination is the most suitable approach to determine the diagnosis and the volume of pulmonary resection
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