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Surgical treatments for esophageal cancers.

ABSTRACT: The following, from the 12th OESO World Conference: Cancers of the Esophagus, includes commentaries on the role of the nurse in preparation of esophageal resection (ER); the management of patients who develop high-grade dysplasia after having undergone Nissen fundoplication; the trajectory of care for the patient with esophageal cancer; the influence of the site of tumor in the choice of treatment; the best location for esophagogastrostomy; management of chylous leak after esophagectomy; the optimal approach to manage thoracic esophageal leak after esophagectomy; the choice for operational approach in surgery of cardioesophageal crossing; the advantages of robot esophagectomy; the place of open esophagectomy; the advantages of esophagectomy compared to definitive chemoradiotherapy; the pathologist report in the resected specimen; the best way to manage patients with unsuspected positive microscopic margin after ER; enhanced recovery after surgery for ER: expedited care protocols; and long-term quality of life in patients following esophagectomy.

SUBMITTER: Allum WH

PROVIDER: S-EPMC4384171 | biostudies-literature | 2014 Sep

REPOSITORIES: biostudies-literature

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Surgical treatments for esophageal cancers.

Allum William H WH Bonavina Luigi L Cassivi Stephen D SD Cuesta Miguel A MA Dong Zhao Ming ZM Felix Valter Nilton VN Figueredo Edgar E Gatenby Piers A C PA Haverkamp Leonie L Ibraev Maksat A MA Krasna Mark J MJ Lambert René R Langer Rupert R Lewis Michael P N MP Nason Katie S KS Parry Kevin K Preston Shaun R SR Ruurda Jelle P JP Schaheen Lara W LW Tatum Roger P RP Turkin Igor N IN van der Horst Sylvia S van der Peet Donald L DL van der Sluis Peter C PC van Hillegersberg Richard R Wormald Justin C R JC Wu Peter C PC Zonderhuis Barbara M BM

Annals of the New York Academy of Sciences 20140901

The following, from the 12th OESO World Conference: Cancers of the Esophagus, includes commentaries on the role of the nurse in preparation of esophageal resection (ER); the management of patients who develop high-grade dysplasia after having undergone Nissen fundoplication; the trajectory of care for the patient with esophageal cancer; the influence of the site of tumor in the choice of treatment; the best location for esophagogastrostomy; management of chylous leak after esophagectomy; the opt ...[more]

PMID: 25266029

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Project description:BackgroundSpontaneous esophageal perforation is a challenging surgical emergency with significant morbidity and mortality, and timely primary repair carries good outcomes. However, direct repair for a delayed spontaneous esophageal perforation is not always feasible and is associated with high mortality. Esophageal stenting can provide therapeutic benefits in the management of esophageal perforations. In this study, we review our experience with placing esophageal stents in combination with minimally-invasive surgical drainage to treat delayed spontaneous esophageal perforations.MethodsWe retrospectively analyzed patients with delayed spontaneous esophageal perforations between September 2018 and March 2021. All patients were treated using a hybrid approach, including esophageal stenting across the gastroesophageal junction (GEJ) to reduce continued contamination, gastric decompression with extraluminal sutures to prevent stent migration, early enteral nutrition, and aggressive minimally-invasive thoracoscopic debridement and drainage of infected material.ResultsThere were 5 patients with delayed spontaneous esophageal perforation treated with this hybrid approach. The mean duration between symptoms and diagnosis was 5 days, and the interval between symptoms and esophageal stent insertion was 7 days. The median time to oral nutrition and to esophageal stent removal was 43 and 66 days. There was no stent migration or hospital mortality. Three patients (60%) had postoperative complications. All patients were successfully resumed on oral nutrition with esophageal preservation.ConclusionsA hybrid approach combining endoscopic esophageal stent placement with extraluminal sutures to prevent stent migration, thoracoscopic decortication with chest tube drainage, gastric decompression, and jejunostomy tube placement for early nutrition was feasible and effective in the treatment of delayed spontaneous esophageal perforations. This technique offers a less invasive treatment approach for a challenging clinical problem which has traditionally carried a high rate of morbidity and mortality.

Dataset Information

Surgical treatments for esophageal cancers.

Publications

Surgical treatments for esophageal cancers.

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