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At least 595 records · Page 33Linked to original sources
PubMed2006

[Clinical experience with silicon pharyngeal tube for pharyngocutaneous fistula and cervical esophagus stenosis].

Total laryngectomy or laryngopharyngectomy are commonly performed for the treatment of laryngeal cancer or hypopharyngeal cancer. However pharyngocutaneous fistula and cervical esophageal stenosis have been reported as postoperative complications of these procedures. We used a silicon pharyngeal tube in cases that developed pharyngocutaneous fistula and cervical esophageal stenosis. The pharyngeal tube was useful for controlling aspiration pneumonia and for starting oral feeding in a case of pharyngocutaneous fistula after a total laryngectomy. It was also helpful for starting oral feeding in a case with cervical esophageal stenosis after total laryngopharyngectomy and free jejunum interposition. This patient was able to maintain a good quality of life until re-operation. Adverse effects from the insertion of the tube included a foreign body sensation and pharyngeal pain that was tolerable with the use of NSAIDs for a short time. Silicon pharyngeal tubes are useful for the treatment of pharyngocutaneous fistula and cervical esophageal stenosis.

Aged↗
PubMed2004

Vocal fold paralysis and progressive cricopharyngeal stenosis reversed by cricopharyngeal myotomy.

Three infants with progressive upper esophageal stenosis had bilateral vocal fold paralysis. The patients were apparently normal at birth and without neurologic abnormality. Cricopharyngeal myotomy, followed by serial dilatations, relieved esophageal stenosis and restored the swallowing function. Vocal fold mobility, to the authors' surprise, also recovered after myotomy in 2 patients. Vocal paralysis persisted in the first patient encountered, although this case was complicated by longstanding tracheostomy. Decannulation in this case was successful at 4 years only after arytenopexy and cricoid interposition grafting. Direct laryngoscopy findings showed weak abductive motion of 1 vocal fold at 14-year follow-up. Loss of vocal function secondary to constriction by a cricopharyngeal band has been previously undocumented. The potential reversibility of both vocal paralysis and esophageal stenosis by surgical cricopharyngeal myotomy is of significant clinical importance.

Constriction, Pathologic↗
PubMed1999

[Endoscopic treatment of malignant stenosis in home care].

At our institute, we have tried to increase the patient's quality of life (QOL) by endoscopic stenting for upper intestinal stenosis due to malignant tumor, which could not be treated by surgery or chemotherapy. We report the endoscopic stenting and home therapy for those patients. The subjects were 44: (esophageal stenosis: 13 cases, biliary stenosis: 31 cases) out of 60 patients who had intestinal stenosis or obstruction, which could not be treated by surgery or chemotherapy. Esophageal stenosis was treated mainly by stenting and laser cautery, and biliary stenosis was treated by drainage using stenting. The home stay period, effective treat period, life survival period, and complications were analyzed in each case. It was found that the mean home stay period, mean effective treatment period, and mean life survival period were 3.4 months, 4.0 months, and 5.5 months, respectively, with esophageal stenosis, and 3.7 months, 4.4 months, 5.5 months with biliary stenosis. Mean home stay period/life survival period was 62% in cases of esophageal stenosis, and 67% in cases of biliary stenosis. Complications were observed in 40.0% of patients with esophageal stenting and in 12.5% with biliary stenting. Esophageal stenting showed a higher incidence of complications; however improvements in the stenting instrument will reduce the number of complications. Endoscopic stenting is thus effective for upper intestinal stenosis due to malignant tumor, especially in increasing the patient's QOL when curative therapy is not indicated, and the patient stays at home. We believe patients with uncurable malignant disease should have home treatment as early as possible.

Aged↗
PubMed2002

Esophageal foreign bodies: a Jordanian experience.

OBJECTIVES: To study the pattern of esophageal foreign bodies (FB) in Jordan and to compare it with other countries. METHODS: This is a retrospective study conducted on all patients (527) who were admitted with esophageal FB during a period of 9 years from January 1992 to January 2000. Two major referral hospitals were involved: the Princess Basma and Al-Bashir hospitals. A data sheet was constructed in which we included: name, age, gender, presenting symptoms, type and site of FB, technique of removal, and complications if present. RESULTS: Of the 527 patients 53% were male and 47% were female.77% were children under the age of 10 years. In children coins were by far the most common FB to be found in the esophagus (68%), while bones were the principal FB to be found in adults (8%). In 89%, the FB was found at the level of cricopharyngeal muscle. Drooling of saliva (72%), dysphagia (71%), and vomiting (24%) were the most commonly presenting symptoms. Both rigid esophagoscopy and Magill forceps techniques were used to remove the FB from the esophagus. The complication rate was 2% which included: esophageal perforation and mediastinitis, esophageal stenosis and esophageal erosions. CONCLUSION: The pattern of esophageal FB in Jordan is not different from other countries.

Adolescent↗
PubMed1989

Long-term injection sclerotherapy treatment for esophageal varices. A 10-year prospective evaluation.

Long-term injection sclerotherapy after proved variceal bleeding was assessed in 245 patients. The majority had alcoholic cirrhosis and the patients were equally distributed between modified Pugh-Child's risk grades A, B, and C. Esophageal varices were eradicated in 88% of the 140 patients who survived long enough for analysis, and remained eradicated for a mean of 19.4 months. The incidence of recurrent variceal bleeding after the first hospital admission was 0.02 bleeding episodes per patient month of follow-up study and was markedly reduced after eradication of varices. The overall cumulative survival rates at 1, 5, and 10 years were 54%, 39%, and 29%, respectively. The prognosis was influenced by the risk grade and the number of variceal bleeds before entering the study and to a lesser extent by the etiology of the cirrhosis. Fifty-two per cent of the patients died during the 10-year period. Liver failure was the major cause of death. Complications were mostly of a minor nature but they became cumulative with time. Minor complications included mucosal slough and injection-site leak, although the latter had an associated mortality risk. Significant esophageal stenosis and esophageal rupture were rare. As a result of this study a more radical surgical policy is proposed for sclerotherapy failures. These are defined as patients in whom varices are difficult to eradicate or who continue to have major variceal bleeds. Such patients should be subjected to either a portosystemic shunt or a devascularization and transection procedure.

Adult↗
PubMed1997

Tracheo-bronchial remnants: a rare cause of dysphagia.

A 14-year-old girl presented with dysphagia since the age of one year. Investigations revealed two strictures at the lower esophagus. Endoscopic mucosal biopsy from the strictures showed pseudostratified columnar epithelium suggesting that tracheobronchial remnants was the cause of the stenosis. Esophageal dilatation failed to relieve her symptoms.

Adolescent↗
PubMed1990

Self-expanding mesh stent for esophageal cancer stenosis.

The implantation of new self-expanding mesh stents (20 mm in diameter, when fully expanded) in a 67-year-old woman with extensive esophageal cancer stenosis is reported. Prosthesis insertion was easily accomplished without the need for general anesthesia. The patient has been doing well since. The potential advantages of the new stenting procedure suggest further investigation.

Aged↗
PubMed1995

[Esophageal dilatation in pediatrics: study of 33 patients].

BACKGROUND: Esophageal dilatation is usually regarded as an effective therapy in a majority of esophageal stenosis in childhood. However, the limited number of pediatric data does not allow definite conclusions on indications and complications of such a procedure. PATIENTS AND METHODS: The files of 33 children whose esophageal stenosis had been treated by dilatation by the same operator between 1983 and 1992 were retrospectively reviewed. The structure mechanisms were: group 1: repair of esophageal atresia (n = 9), group 2: caustic esophagitis (n = 6), group 3: peptic esophagitis (n = 12), group 4: unclassified structures (congenital esophageal stenosis, achalasia) (n = 6). The dilatations were performed under general anesthesia, and the dilatator guide was introduced under endoscopic control. Two methods were used: Savary esophageal bougies and balloon dilatation. A thoracic X-ray was systematically performed after each dilatation. RESULTS: One hundred and fourteen dilatations (3.5 dilatations/child) were performed (range: 1-32 dilatations). Twenty-five of the 33 children (76%) were dramatically improved after mechanical dilatation. Esophageal dilatation was unsuccessful in the eight other patients, seven of them requiring a surgical repair. Complications occurred in 3.4% of the dilatations: one esophageal perforation, one pneumomediastinum and two cardiac arrests (one of vagal origin and 1 after accidental extubation). All patients survived. Efficacy, duration of dilatation and complication rates were not similar in the four groups. CONCLUSIONS: Esophageal dilatation should be considered as a simple and effective procedure when strict security rules are respected by a trained operator.

Adolescent↗
PubMed1995

[Delayed stenosis after esophageal reconstruction with colon interposition 35 years ago].

BACKGROUND: The long-term complication of an anastomotic stenosis with a poststenotic diverticulum in the case of lye chemical burn of the esophagus at the age of 2 prompted us to present this very rare case, in which 35 years ago the defect was bridged with a section of colon. PATIENTS: In case in point, secondary surgical correction was performed six years after the accident. Thirty-five years later, our patient developed a stenosis of the proximal esophagus which made surgical intervention necessary. RESULTS: In this paper, we describe the problems caused by chemical burns in this case (lye), the surgical treatment, and possible complications. CONCLUSIONS: Reliable procedures include reconstruction with a jejunal transplant, pectoralis major flap, microvascular myocutaneous flap, and retrosternal plastic surgery of the colon. A report on diagnostic procedure and operative care is presented.

Adult↗
PubMed2005

The use of a retrievable self-expanding stent in treating childhood benign esophageal strictures.

BACKGROUND/PURPOSE: Esophageal stenting is a popular form of treatment of esophageal strictures in adults but is not widely used in children. The aim of the current study was to investigate whether esophageal stents could be used safely and effectively in the treatment of esophageal stenosis in children. METHODS: Covered retrievable expandable nitinol stents were placed in 8 children with corrosive esophageal stenosis. The stents were removed 1 to 4 weeks after insertion. RESULTS: The stents were placed in all patients without complications and were later removed successfully. After stent placement, all patients could take solid food without dysphagia. Stent migration occurred in one patient and so the insertion procedure was repeated to reposition the stent. During the 3-month follow-up period after stent removal, all children could eat satisfactorily. After 6 months, 2 children required balloon dilation (3 times in one and 5 times in the other). The dysphagia score improved in all patients. CONCLUSIONS: The use of the covered retrievable expandable stent is an effective and safe method in treating childhood corrosive esophageal stenosis.

Alloys↗
PubMed2003

Long-term outcomes and complications of metallic stents for malignant esophageal stenoses.

Thirty patients with malignant esophageal stenosis underwent Ultraflex esophageal stent deployment and were followed up for a maximum of 29 months from June 1995 to August 2001 in Tenri Hospital. Twelve stents were in the upper esophagus, and nine each in the middle and lower esophagus. The procedures were successful and dysphagia scores improved from 2.9 to 0.7. Major complications such as esophagorespiratory fistula, hematemesis, or airway compression occurred in 9 patients, more often in the upper esophagus than in other parts of the esophagus, with no statistical difference. There was a significant difference in the onset of major complications between the upper and middle esophagus, as well as between the upper and middle-lower esophagus (p < 0.05), but no difference in mean survival time between locations, or patients with or without major complications. These results demonstrate that esophageal stent deployment is effective for relieving dysphagia and associating malnutrition. But major complications may occur in the upper esophagus more often and earlier than in other parts.

Aged↗