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Search Results: 1 - 10 of 2817 matches for " Esophageal neoplasm "
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Estudo comparativo entre as anastomoses cervicais esofagogástrica término-terminal com e sem invagina??o após esofagectomia para cancer
Henriques, Alexandre Cruz;Zanon, Aline Biral;Godinho, Carlos Alberto;Martins, Lourdes Concei??o;Saad Junior, Roberto;Speranzini, Manlio Basilio;Waisberg, Jaques;
Revista do Colégio Brasileiro de Cirurgi?es , 2009, DOI: 10.1590/S0100-69912009000500007
Abstract: objective: to assess the incidence of fistula and stenosis of cervical esophagogastric anastomosis with invagination of the esophageal stump into the gastric tube in esophagectomy for esophagus cancer. methods: two groups of patients with thoracic and abdominal esophagus cancer undergoing esophagectomy and esophagogastroplasty were studied. group i comprised 29 patients who underwent cervical esophagogastric anastomosis with invagination of the proximal esophageal stump segment within the stomach, in the period of 1998 to 2007 while group ii was composed of 36 patients submitted to end-to-end cervical esophago-gastric anastomosis without invagination during the period of 1989 to 1997. results: in group i, esophagogastric anastomosis by invagination presented fistula with mild clinical implications in 3 (10.3%) patients, whereas in group ii, fistulas with heavy saliva leaks were observed in 11 (30.5%) patients. the frequency of fistulas was significantly lower in group i patients (p=0.04) than in group ii. in group i, fibrotic stenosis of anastomoses occurred in 7 (24.1%) subjects, and 10 patients (27.7%) in group ii evolved with stenosis, while no significant difference (p=0.72) was found between the two groups. conclusion: in esophagectomy for esophagus cancer, cervical esophagogastric anastomosis with invagination presented a lower rate of esophagogastric fistula versus anastomosis without invagination. stenosis rates in esophagogastric anastomosis proved similar in both approach with or without invagination.
Fístula cervical pós-anastomose esofagogástrica: é possível diminuir a ocorrência?
Fontes, Paulo Roberto Ott;Kruse, Cristine Kist;Waechter, Fábio Luiz;Nectoux, Mauro;Fochesato, Larissa Bittencourt Saggin;Goettert, Gustavo Ferreira;Silva, Maurício Fraga da;Pereira-Lima, Luiz;
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (S?o Paulo) , 2008, DOI: 10.1590/S0102-67202008000400002
Abstract: background: the esophageal cancer is the 6th cause of cancer-related death in brazil, and esophagectomy is the cornerstone of the treatment, not only for the curative cases, but with palliative intent as well. the cervical fistula is a very frequent complication of the procedure with a related incidence between 0,8 and 47,8%. aim: prospective analysis to determine the success of a new alternative technique of cervical anastomosis. methods: prospective analysis of 126 patients, distributed in two groups accordingly to the cervical anastomosis technique. group a (n=96) had cervical anastomosis in two layers, the inner continuous type and outer isolated, followed by redundant tissue. group b (n=25) had a technical variation with suture done without mucosa opening at first. results: this alternative technique for the cervical esophagogastric anastomosis presented zero fistulas. conclusion: this alternative was efficient in decrease fistula rate because it allow best exposition and visualization of the anastomosis, facilitating the suture lines.
Esophageal Cancer in Northeast of Iran
Aledavood A,Anvari K,Sabouri G
Iranian Journal of Cancer Prevention , 2011,
Abstract: Background: Esophageal cancer is the 7th most common cancer in Iran. The northern part of the country shows the highest incidence for this malignancy. In this study we present some epidemiological and clinicopathological characteristics of patients with esophageal carcinoma in this region.Methods: In a cross sectional study, 238 Esophageal cancer patients were enrolled in a prospective study of neoadjuvant chemo-radiation treatment in a 4-year period (2006- 2009). In an oncology clinic their epidemiologic characteristics and clinicopathological findings were registered in a preplanned file. Data consisted of age, sex, race, occupation, residential location, smoking, addiction history, signs and symptoms, blood biochemistry profile, imaging and endoscopic findings. The data were analyzed with the SPSS software.Results: The mean age of the patients was (55% female) 59 years. They were mostly Fars (63%) and Turkmen (13%). Seventy two percent were residents of rural area, 20% were smokers and 22.3% were opium addict and its analogues. Only 1.3% of patients consumed alcohol. The most common presenting symptom was dysphagia (93.7%), mainly grade III dysphagia (53%). Location of tumor in esophagus was in the middle third in 53.4% and lower segment in 44.5%.65 % of the patients had an abnormal esophagogram. On endoscopic evaluation the most common types of tumors were polypoid, vegetative and fungoid, respectively. Mean tumor length was 5.7 cm. The most common histology type was squamus cell carcinoma (99.1%) which was moderately differentiated in 51.3% of these patients. No significant relationship was found between the grade of dysphagia with the macroscopic type and the pathologic grade of the tumor in this study.Conclusion: Squamous cell carcinoma comprised more than 99% of all esophageal cancers in our patients and this histological type is the prominent type in the Northeast of Iran. Middle esophageal segment is the major site for this type of cancer which unfortunately most patients present with grade III. Dysphasia reflects the advanced stage of the disease.
Endoscopic submucosal dissection for superficial esophageal squamous cell neoplasms
Kuniomi Honda,Hirotada Akiho
World Journal of Gastrointestinal Pathophysiology , 2012, DOI: 10.4291/wjgp.v3.i2.44
Abstract: Endoscopic resection is an effective treatment for non-invasive esophageal squamous cell neoplasms (ESCNs). Endoscopic mucosal resection (EMR) has been developed for small localized ESCNs as an alternative to surgical therapy because it shows similar effectiveness and is less invasive than esophagectomy. However, EMR is limited in resection size and therefore piecemeal resection is performed for large lesions, resulting in an imprecise histological evaluation and a high frequency of local recurrence. Endoscopic submucosal dissection (ESD) has been developed in Japan as one of the standard endoscopic resection techniques for ESCNs. ESD enables esophageal lesions, regardless of their size, to be removed en bloc and thus has a lower local recurrence rate than EMR. The development of new devices and the establishment of optimal strategies for esophageal ESD have resulted in fewer complications such as perforation than expected. However, esophageal stricture after ESD may occur when the resected area is larger than three-quarters of the esophageal lumen or particularly when it encompasses the entire circumference; such a stricture requires multiple sessions of endoscopic balloon dilatation. Recently, oral prednisolone has been reported to be useful in preventing post-ESD stricture. In addition, a combination of chemoradiotherapy (CRT) and ESD might be an alternative therapy for submucosal esophageal cancer that has a risk of lymph node metastasis because esophagectomy is extremely invasive; CRT has a higher local recurrence rate than esophagectomy but is less invasive. ESD is likely to play a central role in the treatment of superficial esophageal squamous cell neoplasms in the future.
The role of laparoscopy in diagnosing metastasis of upper gastrointestinal tract malignancies
F. Eshghi,M. Jamshidi,M. Jamshidi
Journal of Mazandaran University of Medical Sciences , 2006,
Abstract: Background and purpose: Upper gastrointestinal tract cancers are important malignancies in the entire world. Many Diagnostic procedures are frequently used for staging gastrointestinal malignancies. Laparoscopy has emerged as a good staging modality for most gastrointestinal cancers than many other preoperative modalities.Materials and Methods: Patients with gastrointestinal tract malignancies were selected for evaluation from 2000 to 2001. After complete physical examination and paraclinical evaluations, all patients underwent laparoscopy with general anesthesia and biopsies prepared from metastasis followed by laparotomy. Data were analyzed by statistical tests.Results: Fourty three patients, 41%female and 59% male with a mean age of 61.25±14 years were studied. Sensitivity and specifity of laparoscopy in diagnosing lymph node metastasis of upper gastrointestinal tract malignancies were 83.33% , 100% respectively. These indices were 75% and 100% in liver metastasis. Positive and negative predictive values of lymph node metastasis were 100% and 89.3% respectively and 100% and 20% in liver metastasis.Conclusion: Preoperative laparoscopy is an effective method for diagnosing metastasis in patients with gastrointestinal tract cancers and can prevent many unnecessary laparotomies.
Compara??o dos tratamentos do carcinoma espinocelular avan?ado do esofago pela teleterapia exclusiva e pela teleterapia associada à braquiterapia
Samea, Renato;Louren?o, Laercio Gomes;
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (S?o Paulo) , 2011, DOI: 10.1590/S0102-67202011000400004
Abstract: background: squamous cell carcinoma of the esophagus is still a difficult tumor to treat with very poor prognosis. aim: to compare the response to teletherapy treatment (external beam radiotherapy) alone versus teletherapy combined with brachytherapy for patients with advanced squamous cell carcinoma of the esophagus. methods: were studied 49 patients with advanced squamous cell carcinoma of the esophagus on clinical stage iii (tnm-1999). they were separated into two groups. the first, underwent radiation therapy alone with linear accelerator of particles, average dose of 6000 cgy and the second to external beam radiation therapy at a dose of 5040 cgy combined with brachytherapy with iridium 192 at a dose of 1500 cgy. brachytherapy started one to two weeks after the end of teletherapy, and it was divided into three weekly applications of 500 cgy. age, gender, race, habits (smoking and drinking), body mass index (bmi), complications with treatment benefits (pain relief and food satisfaction) and survival were analyzed. results: the quality of life (food satisfaction, and pain palliation of dysphagia) were better in the group treated with external beam radiation therapy combined with brachytherapy. survival was higher in the brachytherapy combined with external beam radiation therapy alone. conclusion: although the cure rate of squamous cell cancer of the esophagus is almost nil when treated with irradiation alone, this therapy is a form of palliative treatment for most patients in whom surgical contraindication exists.
Identification of human papillomavirus in esophageal squamous papillomas
Olga L Bohn, Leticia Navarro, Jesus Saldivar, Sergio Sanchez-Sosa
World Journal of Gastroenterology , 2008,
Abstract: AIM: To investigate the presence of human papillomavirus (HPV) in esophageal squamous papilloma (ESP) and determine p16, p53 and Ki67 expression in a Mexican cohort.METHODS: Nineteen cases diagnosed as ESP, corresponding to 18 patients were reviewed; nineteen cases of normal esophageal mucosa were used as negative controls. HPV detection was performed by amplified chromogenic in situ hybridization (ACISH) using a wide spectrum-cocktail probe and PCR.RESULTS: The average age at presentation was 46.3 years (range 28-72 years). Patients included four (22.22%) males and 14 (77.77%) females. The most frequent location was upper third (11 cases), followed by middle third (3 cases) and unknown site (5 cases). Immunohistochemistry (IHC) revealed basal and focal p53 expression in 17 cases (89%); p16 was expressed in eight cases (42.10%) and the Ki67 index ranged from 10% to 30%. HPV was detected in 14 out of 16 cases (87.5%) by ACISH: Twelve showed diffuse nuclear patterns and two showed granular patterns. HPV DNA was identified by PCR in 12 out of 14 cases (85.7%). Low-risk HPV types were detected in the most of the cases.CONCLUSION: This study provides identification of HPV infection in almost 80% of ESP using either ACISH or PCR; overall, all of these lesions show low expression of cell-cycle markers. We suggest ACISH as an alternative diagnostic tool for HPV detection in ESP.
Avalia??o da express?o imunoistoquímica da proteína p16INK4a no adenocarcinoma de es?fago
Osanai, Mário Henrique;Edelweiss, Maria Isabel Albano;Meurer, Luise;Vilwock, Maitê de Mello;Cavazzola, Leandro Totti;Ribeiro, Guilherme;Schirmer, Carlos Cauduro;Gurski, Richard Ricachenevsky;
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (S?o Paulo) , 2011, DOI: 10.1590/S0102-67202011000400006
Abstract: background: the esophageal adenocarcinoma shows an increasing frequence in the last decades, specially in the developed countries. the barrett′s esophagus is accepted as the major premalignant lesion and the metaplasia-dysplasia-adenocarcinoma sequence presents a lot of genetic changes since its early events. the alterations in p16ink4a are frequent in barrett′s esophagus and esophageal carcinoma. aim: to verify the prevalence of the immunohistochemical expression of the p16ink4a protein in patients with esophageal adenocarcinoma. methods: the study population consisted of 37 patients with resected esophageal adenocarcinoma. the p16ink4a protein expression was determined by immunohistochemistry using primary antibody p16ink4aab-7, clone 16p07 neomarkers and assessed according to the immunoreactive scoring system (irs). results: of 37 analyzed patients, the most were male (86,5%) and the advanced disease was predominant (stages iii and iv = 67,5%). in 12 (32,4%) the immunohistochemistry was positive for p16ink4a.there was no significative relation between the protein expression and the degrees of histological differentiation of the biopsies and surgical especimens (p=0,81) neither with the staging (p=0,485). conclusion: the lost of the immunohistochemical expression of the p16ink4a protein in this study suggests that p16 is enroled in the carcinogenesis of the adenocarcinoma of esophagus.
食管癌淋巴结清扫的沿革及新概念:食管全系膜切除
Current Trend of Lymph Node Dissection for Esophageal Cancer and New Concept: Total Mesoesophagus Excision
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杜泽森, 傅俊慧
Hans Journal of Surgery (HJS) , 2013, DOI: 10.12677/HJS.2013.21001
Abstract: 对食管癌进行系统性的淋巴结清扫是提高手术根治率及术后长期生存率的关键,改善外科治疗的长期效果。食管全系膜切除是基于食管系膜的组织胚胎学、解剖学特点提出的新的概念,强调完整的切除食管及其周围血管、脂肪组织,有望成为食管癌手术的质量控制标准。
Systemic lymph node dissection helps increase the radical resection rate and the distant prognosis of esophageal cancer. Total mesoesophagus resection is a new concept based on embryology and anatomy of mesoesophagus which emphasize complete dissection including esophagus and peripheral vessels and fatty tissue. It is hoped to become quality control standard of esophagectomy.
Sobrevida de pacientes con cáncer de esófago sometidos a esofagectomía total torácica
Braghetto M,talo; Csendes J,Attila; Cornejo O,Aquiles; Amat V,José; Cardemil H,Gonzalo; Burdiles P,Patricio; Korn B,Owen;
Revista médica de Chile , 2000, DOI: 10.4067/S0034-98872000000100009
Abstract: background: esophageal carcinoma has a dismal prognosis. several authors have reported a very low survival in chile. aim: to report the survival of patients with esophageal carcinoma, subjected to esophageal resection. material and methods: analysis of 108 patients subjected to thoracic esophageal resection between 1985 and 1996. patients were classified according to the location of the tumor and its staging. results: eleven patients died in the immediate postoperative period and 90 patients were followed. in 53 the exact cause of death was determined. global five years survival was 29% and median survival was 18 months. survival was 100% in stage i tumors. adjuvant therapy resulted in a better survival of stage iii tumors. survival of stage iv tumors was worst than stage i to iii tumors. there was no survival difference between squamous carcinoma or adenocarcinoma. tumors located in the superior third of the esophagus had a worst prognosis. causes of death were mediastinic metastases, local recidivism, pleural or pulmonary metastases and less frequently, brain, bronchial or bone metastases. conclusions: the survival of these, patients with esophageal carcinoma did not differ from the figures reported abroad. (rev méd chile 2000; 128: 64-74)
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