1,720,975 research outputs found
[Leiomyosarcoma of the esophagus].
No full textThe authors describe the anatomo-clinical characteristics of a case of
leiomyosarcoma of the oesophagus which came under their observation, emphasizing
its rarity: 39 cases in the literature examined. They then discuss the numerous
problems that this neoplasia involves, especially diagnostic differentiation from
other sarcomas and the pseudo-sarcomatous reaction of the stroma during the
course of carcinomas. Lastly they divide leiomyosarcoma of the oesophagus into
polypoid forms and infiltrating forms, owing to the different therapeutic and
prognostic implications that such distinction implies
[Physiopathology of the pharyngo-esophageal junction and indications for myotomy of the upper esophageal sphincter].
No full textPrimary treatment of esophageal achalasia. Long-term results of myotomy and Dor fundoplication.
No full textFrom 1976 to 1989, 206 patients referred for primary treatment of esophageal
achalasia underwent transabdominal Heller's myotomy and anterior fundoplication
according to the Dor technique. In the majority of the patients, the cardia was
not mobilized, and the myotomy was extended in length for about 10 cm (8 cm on
the esophagus and 2 cm on the stomach). There was no operative mortality. Two
patients (0.9%) required reoperation due to bleeding from the myotomy site in one
and leakage from the gastrotomy site in the other. One hundred ninety-three
patients entered the follow-up study and were followed up from 12 to 144 months
(median, 64.5 months). Five patients died during the follow-up of unrelated
diseases, and in one patient, an esophageal cancer infiltrating the trachea was
discovered 26 months after the operation. Clinical results were excellent or good
in 93.8% of the patients, and fair in 2.6%. Disabling dysphagia recurred in seven
patients (3.6%), six of whom required pneumatic dilation for relief and one
patient who underwent reoperation because of a paraesophageal hiatal hernia.
Postoperative roentgenographic studies showed a significant reduction in the mean
value of the maximal esophageal diameter. Esophageal manometry showed a
significant reduction of lower esophageal sphincter pressure and length over
preoperative values. Twenty-four-hour esophageal pH monitoring showed an abnormal
acid exposure in seven (8.6%) of 81 patients tested. Of these patients, one had
erosive esophagitis on endoscopy. Esophageal transit scintigraphy, performed in
11 patients, showed a significant improvement of transit time in the erect
position compared with preoperative values. We concluded that transabdominal
esophagomyotomy combined with Dor fundoplication is a safe, effective, and
durable procedure in the treatment of esophageal achalasia
LA CROMOESOFAGOSCOPIA: CORRELAZIONE TRA LO STUDIO CITOISTOLOGICO E LA COLORAZIONE VITALE PERENDOSCOPICA NELLA DIAGNOSI DEL CANCRO DELL'ESOFAGO CONCLAMATO
No full text
Esophagogastric anastomotic leakage.
No full textAnastomotic leakage of esophagogastric anastomoses can be prevented by
administering adequate preoperative nutritional support and by employing
mechanical circular staplers. In a series of 299 intrathoracic anastomoses, 35
leakages were observed, 11 of which gave asymptomatic radiological findings. In a
series of 46 cervical anastomoses, nine leakages were observed. In the majority
of cases conservative treatment was adopted. This is based upon external drainage
of septic collections, gastric emptying, antibiotics and intensive nutritional
care. The mortality rate in cases of anastomotic fistulas was 1.74% (6 patients)
in the patients with esophagogastric anastomoses
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