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Query: UMLS:C0011168 (dysphagia)
 15,644 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Curative resection is impossible in most patients with carcinoma of the esophagus or malignant tracheoesophageal fistulas, because of local tumor invasion or distant metastases. Optimal palliative therapy in these patients should relieve dysphagia and aspiration and restore the ability to swallow comfortably. This report describes a technique for palliation of carcinoma of the esophagus with a substernal gastric bypass after exclusion of the thoracic exophagus with the GIA surgical stapler. The results of this procedure in 10 patients with advanced malignant disease are discussed. Although postoperative morbidity and mortality rates were high, the quality of life achieved with this method of palliation was gratifying. Substernal gastric bypass of the excluded thoracic esophagus is an effective alternative to feeding tubes, prolonged radiation therapy, esophagogastrectomy, or colon bypass in patients with incurable, malignant esophageal disease.
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PMID:Substernal gastric bypass of the excluded thoracic esophagus for palliation of esophageal carcinoma. 5 64

We retrospectively reviewed our experience with palliative dilation for dysphagia in esophageal carcinoma. During a 3-year period 26 patients with squamous-cell carcinoma of the esophagus underwent peroral esophageal dilation for relief of dysphagia. Twenty-four were able to resume a soft or regular diet after dilation. This improvement was accomplished with low morbidity and no mortality. Dilations were done without additional risk in patients with malignant tracheoesophageal fistulae and in patients undergoing radiation therapy. We conclude that esophageal dilation can be done safely and effectively in patients with squamous-cell carcinoma of the esophagus. Palliative dilation can significantly improve the quality of life for these patients and should be considered an important part of their management plan.
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PMID:Palliative dilation for dysphagia in esophageal carcinoma. 8 17

A series of 105 patients with dysphagia due to inoperable carcinoma of the oesophagus or cardia of the stomach, and 11 patients with dysphagia secondary to malignant medistinal nodes, was treated by intubation with a Celestin tube. The hospital mortality was high but 81 patients left hospital and 29 were still alive at 6 months. The prognosis for those with dysphagia due to malignant posterior mediastinal nodes was very poor, with no survivors at 6 months. Oesophageal perforation was a serious operative complication, with a hospital mortality of 83 per cent. Chest and wound infections were the most common postoperative complications occurring in 28 and 20 per cent of the patients, respectively. The restoration of swallowing was satisfactory in the majority of survivors although readmission with a blocked or displaced tube was not uncommon.
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PMID:The Celestin tube in the palliation of carcinoma of the oesophagus and cardia. 8 88

Between January 1, 1970, and March 1, 1979, 153 patients with carcinoma of the esophagus or cardia were seen at the Lahey Clinic; 124 (81%) underwent surgical exploration and 102 (82.3%) were found amendable to resection. This report concerns the 82 patients operated on by the senior author, 72 of whom (87.8%) had surgical resection. A variety of resective techniques were used but currently esophagogastrectomy and esophagogastrostomy is preferred, a left thoracotomy being used for low lying lesions; upper thoracic and cervical lesions are approached through a combined abdominal and right thoracic approach or esophagectomy with cervical esophagogastrostomy and without thoracotomy is used. Two deaths occurred within 30 days of operation, a hospital mortality rate of 2.8%. Significant complications developed in 11 patients (15.3%). The average survival was 20.8 months, and satisfactory long-term relief of dysphagia was achieved in 91.2% of patients. An aggressive surgical approach to the management of patients with carcinoma of the esophagus or cardia is justified, for esophagogastrectomy and esophagogastrostomy is applicable to the majority of patients; can now be performed at low risk with a reasonable period of hospitalization; and provides satisfactory long-term palliation.
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PMID:Esophagogastrectomy for carcinoma: current hospital mortality and morbidity rates. 9 17

Dysphagia is a symptom of organically or functionally conditioned diseases of the oesophagus. In all circumstances it demands an immediate clarification of the etiology considering appropriate therapeutical measures and above all may be first reference to the carcinoma of the oesophagus.
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PMID:[Dysphagia, diagnostic and therapeutic measures]. 12 85

Dysphagia is the most disabling symptom for patients with carcinoma of the oesophagus. Bowel segment bypass surgery offers satisfactory relief, but is often complicated by anastomotic leakage with its associated high mortality. Poor vascular perfusion of the cervical end of a bypass segment is an important cause of breakdown and leakage. A technique of cervical-mesenteric vascular anastomosis to improve the blood supply of the bypass is described and a case is reported.
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PMID:Mesenteric-cervical vascular anastomosis as an adjunct to oesophageal bypass surgery for carcinoma. 29 16

A prospective study of 595 patients treated by the Thoracic Surgical Unit (TSU) at the University College Hospital (UCH), Ibadan between July 1975 and December 1977 was carried out to determine the pattern of thoracic surgical diseases in Nigeria and to prove or disprove the rarity of certain cardiopulmonary diseases in tropical Africa. This review shows that pyogenic infections of the lung and pleura constitute the largest percentage (38.5) of the thoracic surgical diseases in Nigeria. Although pulmonary tuberculosis accounts for only 23.4 percent of our total inpatient load, it constitutes about 60 percent of our outpatient clinic practice. Cardiovascular diseases form 12.9 percent, notably congenital and acquired valvular heart diseases. An interesting finding was the occasional association of pyomyositis with pyogenic pericarditis and empyema thoracis. This triad is being investigated. Chest trauma was the most common thoracic surgical emergency accounting for 9.2 percent of the total thoracic surgical pathology. The most common causes of dysphagia are strictures from corrosive esophagitis, achalasia, and carcinoma of the esophagus. Present experience confirms the rarity of hiatus hernia, reflux esophagitis, atherosclerotic cardiovascular disease, and, perhaps, carcinoma of the lung among Nigerians.
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PMID:Pattern of thoracic surgical diseases in Nigeria: experience at the University College Hospital, Ibadan. 70 99

We describe the use of polyvinyl esophageal prosthetic tubes to treat 14 consecutive patients with malignant strictures and tracheoesophageal fistula from carcinoma of the esophagus. We found these prosthetic tubes easy to construct, simple to insert, and that their use improved the quality of remaining life in most patients by diminishing dysphagia and incessant coughing from pulmonary aspiration.
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PMID:Esophageal prosthesis in cancer. 70 51

The seriousness of dysphagia as a symptom is emphasised. Two illustrative cases are described in which carcinoma of the oesophagus causing dysphagia was diagnosed late. The importance of early barium studies and early oesophagoscopy is stressed. The poor results of management of carcinoma of the oesophagus associated with late diagnosis are illustrated in the patient data presented.
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PMID:Dysphagia: caveat oesophagum. 106 26

Between January 1975 and December 1989, the Cardiothoracic Unit of the University College Hospital, Ibadan (U.C.H.) carried out 47 oesophageal replacement procedures using the stomach. The ages of the patients ranged from 3 to 75 years (mean = 53.2 +/- 19.3 years). There were 24 males and 23 females. The indications for oesophageal replacement were as follows: Carcinoma of the oesophagus--34 patients (73.9%), Corrosive stricture--9 patients (17.4%), peptic stricture--1 patient (2.2%), granulomatous oesophageal lesion--1 patient (2.2%), submucous cysts--1 patient (2.2%), oesophageal perforation--1 (2.2%). Twenty patients (58.8%) with oesophageal carcinoma died between 9 and 33 days after operation. The patients with oesophageal perforation, granulomatous lesion and submucous cysts died from sepsis 8, 13 and 6 days respectively after operation due to anastomotic leak. Three patients with corrosive stricture (24%) died 10, 13 and 15 days respectively after operation. All the other 21 (54.7%) patients survived with good results as judged by the absence of dysphagia. Eight of the fourteen surviving patients with carcinoma are lost to follow-up and are presumed dead. There were two intra-operative deaths (4.3%). The operative approaches used were: Transthoracic (21 patients; 9 deaths), Transhiatal oesophagectomy (14 patients; 9 deaths) and retrosternal route (12 patients; 8 deaths). In terms of morbidity, more complications were observed with the transhiatal oesophagectomy (Orringer's technique). It is concluded that whereas oesophagoplasty with the stomach offers good results in patients with benign strictures, the results with carcinoma of the oesophagus in our environment is poor.
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PMID:Oesophageal reconstruction using the stomach. 130 85


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