1,721,305 research outputs found
Total esophagectomy without thoracotomy: results of a European questionnaire (GEEMO).
No full textThe results of a questionnaire answered by the European Members of the GEEMO
concerning esophagectomy without thoracotomy are reported and discussed. 172
cases of esophagectomy without thoracotomy following benign lesions and 666 cases
following various levels of esophageal neoplasia were grouped in the 26 Centers
that have answered the questionnaire amounting to a total of 838 cases. The most
frequent indications for benign lesions were as follows: decompensated or
relapsed megaesophagus (83 cases), acute or stabilized lesions caused by caustic
agents (59 cases), stenoses from gastroesophageal reflux (17 cases), scleroderma
(7 cases) and spontaneous or iatrogenic perforation (6 cases). Concerning the
esophageal site where the technique was employed with esophageal carcinoma, the
most frequent was the cervical (201 cases), then the lower (150 cases), the
middle (91 cases) and upper thirds of the esophagus (48 cases). Adenocarcinoma of
the cardia seems to be an additional indication for many Surgeons to use
esophagectomy without thoracotomy (142 cases). In general, the most frequent
intra-surgical complications (from benign and malignant lesions) were as follows:
pleural lesions (34.4%), lesions of the left recurrent nerve (7.8%), severe
endo-mediastinic hemorrhages (8.5%), tracheo-bronchial (1.5%) and thoracic duct
(0.5%) lesions. The intra-operative mortality was 0.36%. The post-operative
complications were as follows: pleural effusion (17.8%), anastomotic fistulas
(15.2%), hemothorax (5%) and post-operative mortality (10.3%). Cancer of the
cervical esophagus and adenocarcinoma of the cardia were considered sensitive to
this radical treatment whereas in intra-thoracic cancer it can have only a
palliative effect
IL TRATTAMENTO PALLIATIVO DEI CARCINOMI DELL'ESOFAGO E DEL CARDIAS CON LA ND: YAG LASERTERAPIA
No full text[Costs and benefits of mechanical sutures in esophageal surgery].
No full textThe cost/benefit ratio of mechanical sutures is a controversial issue. Aim of
this work was to compare the cost of esophago-visceral anastomoses performed with
staplers versus the cost of conventional anastomoses. Not only the cost of the
material, but also the economical impact of the hospital stay and operative
complications was evaluated. Results show a statistically significant decrease of
morbidity in patients treated with mechanical sutures (3.7% vs 18.8%, p =
0.0001). The overall cost of a single mechanical suture was markedly lower than
that of a single manual suture (934.000 vs 2,209.000 Italian lira). We conclude
that a significant decrease of hospital cost can be expected using mechanical
sutures. It has to be noted, however, that in order to achieve such results, an
adequate surgical training with staplers is mandatory
INTERVENTO DI DEVASCOLARIZZAZIONE ESOFAGO-GASTRICA CON TRANSEZIONE MECCANICA ESOFAGEA
No full text86° CONGRESSO SOCIETA' ITALIANA DI CHIRURGI
Therapeutic options for cancer of the hypopharynx and cervical oesophagus.
No full textBetween 1980 and 1990, 291 patients with a cancer in the cervical area of the
oesophagus were admitted to our Department: in 187 the cancer was located mainly
in the cervical region, 76 in the hypopharynx and 28 had a tumour that had spread
to the cervical oesophageal region following laryngectomy. Most tumours of the
hypopharynx involved the cervical oesophagus when it was often difficult to
define the site of origin. 153 patients (53%) underwent surgical resection which
included a modified neck dissection followed by different kinds of
reconstruction. 96 patients underwent pharyngogastric anastomosis. Twenty
anastomotic leaks (23%) were recorded including both those clinically evident and
asymptomatic ones detected radiologically. Moreover, segmental proximal necrosis
was seen in ten patients. Hospital mortality rate after pharyngogastric
anastomosis was 14.7% (14/95). Colon interposition was used in 11 patients. Two
anastomotic leaks and two partial necroses were observed. Hospital mortality was
18% (2/11). Eighteen patients underwent laryngopharyngectomy and cervical
oesophagectomy with reconstruction performed by means of revascularized jejunal
loop. One anastomotic leak was observed and hospital mortality was nil in these
cases. Twenty-four patients underwent total oesophagectomy with larynx
preservation when the cancer was located at least 2 cm below the upper
oesophageal sphincter. Five anastomotic leaks and two partial necroses occurred
and hospital mortality was 8.3% (2/24) in these patients. The remaining five
patients operated on underwent miscellaneous surgical procedures with one
postoperative death. Overall survival for resections considered curative was
21%:37% for hypopharyngeal and 18% for cervical cancers respectively, while it
was nil at three years after palliative resection and total oesophagectomy with
larynx preservation.(ABSTRACT TRUNCATED AT 250 WORDS
CINQUE ANNI DI ESPERIENZA NEL TRATTAMENTO SCLEROSANTE DELLE VARICI ESOFAGEE ANALISI DEI RISULTATI, VALUTAZIONE DELLE INDICAZIONI, PROGETTI DI STUDIO
No full textENDOSCOPIC APPLICATION OF BILARY PROSTHESES AND DRAINS IN BILIO-PANCREATIC PATHOLOGY
No full textI.F.= 0.76
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