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[Blood coagulation disorders of circulation in the transplant and their prevention in small intestine esophagoplasty].

An analysis of 158 completed esophagoplastics has shown that necroses of the transplant made their appearance in 7.8% of cases, fistulas of anastomoses--in 38%. The basis of pathogenesis of these complications is microthromboses of venules and small veins of the intramural blood circulation of the mobilized small intestine transplant (syndrome of local hypercoagulation). The novocain-heparin blockade and postoperative antiaggregation infusion therapy is an effective method for prevention of intestinal necroses in the postoperative period.

Animals↗

Long-term results after esophagoplasty with colon. An endoscopic study.

Eight patients from a series of 13 having esophageal resection and colon interposition for benign disease have been evaluated by endoscopic testing, with special emphasis on the mucosal long-term changes of the colon segment and their histologic documentation. The average follow-up period was 7.2 years. All patients were in a satisfactory nutritional state but described problems associated with eating, such as regurgitation of undigested foods and substernal postprandial heartburn. No stricture was present but endoscopy confirmed the existence of food in the haustra. There was no gross evidence of colitis but the histological evaluation revealed inflammatory cell infiltration or fibrosis in all patients but one. It is believed that the main cause of mucosal damage is the prolonged cascading of food and delayed emptying, leading to digestion in the haustra.

Colon↗

[Radiologic methods in the evaluation of upper esophagoplasties].

Post-operative radiologic control of esophageal plastic surgical procedures in pathologic conditions of the cervical esophagus involves difficulties due to the poor collaboration of the patient, who swallows only small quantities of contrast medium. Contrast medium injection through esophageal-gastric probes, and its reflux toward the cervical region with the Trendelemburg position and/or straining, enables the demonstration of fistulas otherwise unrecognized.

Administration, Oral↗

[A new technic of gastric tube esophagoplasty in children].

In cases of caustic oesophageal strictures that need oesophagoplasty, the removal of the injured oesophagus is always necessary--a fact that demands a new transthoracic operation. The authors describe a technique which combines, in a one stage operation, the blunt total transmediastinal oesophagectomy and reverse gastric tube oesophagoplasty, this being placed in the posterior mediastinum in the bed of the oesophagus removed by eversion stripping. The authors carried out thirteen oesophagoplasties of this type with no mortality and no severe complications.

Adolescent↗