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PubMedDate not supplied

[Post-caustic esophageal stenosis].

This study treats the last 13-year experience of the Surgical Department from the Fundeni Hospital Bucharest (Romania) regarding the surgery of the postcaustical esophageal stenoses. The series is composed of 25 patients (10 males and 15 women), with ages between 19 and 58 years. The patients were admitted in our unit at an interval between 2 months and 20 years from the caustical ingestion. In 20 cases we preferred seriate procedures (gastrostomy or jejunostomy as a first operation, followed after 2 months to 20 years by a reconstructive procedure). The reconstructive operation was accompanied by resection of the stenotic esophagus in 15 cases (60%); in 10 cases we performed a bypassing (without resection) presternal esophagoplasty. Resection of the esophagus implied a combined abdomino-thoracic approach in 10 cases and an cervico-thoraco-abdominal approach in 5 (depending upon the extent of the lesions). The early postoperative course was complicated by anastomotic leakage's in 5 patients (20%) and by pulmonary complications in another 5 (20%) cases. There were no postoperative deaths. The late follow-up showed a good functional result in 24 patients with medium weight gain of 2.6 kilograms and a normal social reintegration. In conclusion, we consider that the esophagus resection in postcaustical stenoses is indicated when there are no counterindications, with a low morbidity when it is performed in specialized surgical services.

Adult↗
PubMedDate not supplied

[Unusual late complication after esophagoplasty type Gavriliu II for esophageal stenosis from chemical burns--cancer of the esophagoplasty tube].

We present the case of a 56 year old female, who in 23 years after esophagoplasty type Gavriliu II, with pre-sternal tube for esophageal chemical burn stenosis, develops a cancer in the upper third of the gastric tube, with a fast evolution to malnutrition, through lumen obturation. The evolution post-esophagoplasty was marked by malfunction of the neo-esophagus, characterized through dysphagia and distal dilatation, requiring many abdominal and pre-sternal reinterventions. The objective of the present surgical intervention was to assure a way for enteral nutrition (gastrostomy for feeding) and to extirpate the gastro-esophagoplasty tube. It is discussed the characteristic feature of the case: the difficulty of the stage-evolutive integration of this malignant disease location, the etiopathogenic factors that contributed to the malignant evolution of the antral portion of the gastro-esophagoplasty tube, the limits of the surgical treatment.

Adenocarcinoma↗
PubMed2002

Successful new treatment for intractable cervical esophageal stenosis of a jejunal segment transpositioned with a vascular anastomosis: report of a case.

Strictures of the alimentary tract are conventionally treated by fluoroscopically guided bouginage and endoscopic balloon dilation, which is often very effective. However, severe and recurrent stenosis associated with ischemic injury in a jejunal segment transpositioned with a vascular anastomosis after reconstruction for cervical esophageal cancer is an intractable problem. We describe a new method using a Steno-Cutter to successfully treat a patient with this type of stricture following surgery for cervical esophageal cancer. The positive results achieved in this case suggest that our new method could represent a promising option of treatment for strictures when conventional modalities fail.

Adenocarcinoma↗