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

A study was undertaken to demonstrate the safety, efficacy and value of esophageal balloon cytology in the diagnosis of esophageal lesions and as a tool in screening a high-risk patient population. The sampling was performed 110 times on 96 patients, 11 with known obstructive carcinoma of the esophagus and 85 thought to be at risk for esophageal cancer: 74 with treated or untreated cancer of the head and neck area and 11 with dysphagia or other findings requiring clarification. The method was well tolerated by the patients, and the cytologic smears were of excellent quality. Malignant or suspicious cells were found in smears from 7 to 11 patients with documented esophageal cancer and in 7 of 85 patients believed to be at risk. In the latter group there were three unsuspected recurrent cancers of the oropharyngeal region and one unsuspected carcinoma in situ of the esophagus. There were no false-suspicious or false-positive results. This noninvasive technique of esophageal cytology obviously deserves additional trials as an adjunct in the diagnosis of carcinoma of the head and neck and upper gastrointestinal tract, especially in high-risk patients.
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PMID:Use of the esophageal balloon in the diagnosis of carcinomas of the head, neck and upper gastrointestinal tract. 658 46

Patients with incurable carcinoma of the esophagus or the cardia have a miserable life, without being able to swallow and with a risk for pulmonary complications secondary to aspiration of secretion from the esophagus. All efforts should be made to give these patients relief from dysphagia. Our experience indicates that the quality of life may be dramatically improved after dilatation or intubation which restores the ability to swallow, thereby reducing the risk for pulmonary complications.
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PMID:Malignant stenosis of the esophagus treated with dilatation or intubation. 659 68

Polypoid carcinoma of the esophagus is a rare variant of squamous carcinoma, which occurs typically in elderly patients who present with symptoms of dysphagia. This tumor has been given a variety of names, including spindle cell carcinoma, carcinosarcoma, and pseudosarcoma. These designations reflect the controversy surrounding the nature of the spindle cell component of this lesion. We have studied a case of polypoid carcinoma of the esophagus with immunoperoxidase staining for keratin which has been shown to be specific for epithelial cells. Positive staining for keratin was demonstrated in both the carcinomatous and spindle cell "sarcomatous" appearing components of the tumor, supporting the contention that this tumor is of entirely epithelial origin.
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PMID:Polypoid squamous carcinoma of the esophagus. A case report with immunostaining for keratin. 661 13

Palliative treatment of upper gastrointestinal tract obstruction was undertaken by endoscopic laser therapy in 6 patients with carcinoma of the oesophagus or stomach. All had dysphagia for solids on admission and were considered unsuitable for surgery or radiotherapy. Three were in sites unsuitable for placement of an endoscopic prosthesis. The tumours occluded up to 90 per cent of the lumen (2 squamous and 4 adenocarcinomas). Treatment was carried out under direct vision, the laser wave guide being passed through the biopsy channel of a standard endoscope. Superficial tumour vaporized immediately using energies of 2-10 000 J per session, whereas deeper layers sloughed over the succeeding 2-3 days. Two to six treatments were required to relieve dysphagia and there were no major complications. Quantitative barium studies before and after treatment showed a significant increase in luminal diameter. These patients could eat solid food after treatment and all were able to go home.
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PMID:Laser recanalization of obstructing foregut cancer. 669 1

Eighteen patients with unresectable carcinoma of the esophagus were surgically intubated with the Celestin tube. Twelve patients (66.7%) had good palliation and relief of dysphagia. The operation mortality rate was 16.7%, which is in accordance with figures reported for endoscopic intubation of malignant strictures of the esophagus.
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PMID:Permanent indwelling Celestin tubes in malignant esophageal strictures. 669 86

Nutritional assessment and requirements of patients with carcinoma of the esophagus treated by surgery are based on three series of patients: 1) the nutritional state of 22 assessed on admission, using recognized nutritional markers, the majority of whom were found nutritionally deficient; notably 72% were in negative nitrogen (N) balance. 2) Another series of 52 patients was based on the relationship between dysphagia and loss of weight and negative N balance; 48% were severely dysphagic and had lost an average 8.5% of their usual weight, and 89% were in negative N balance. Thus, the association between the two clinical markers and the N balance was clearly indicated. 3) Postoperative calorie and N requirements necessary to maintain a positive N balance were assessed and found to be 40 to 45 kcal/kg body wt and 0.2 to 0.25 g N/kg body wt.
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PMID:Parenteral feeding in patients with carcinoma of the esophagus treated by surgery: energy and nitrogen requirements. 677 19

Gastrostomy feeding has been a well established form of nutritional support for patients presenting with total dysphagia for carcinoma of the oesophagus. More recently, total parenteral nutrition has proved to be efficient and safe, offering an alternative to gastrostomy feeding. Twenty-four patients were randomly selected into two groups to compare the efficacy of total parenteral nutrition and gastrostomy feeding with respect to nitrogen balance and weight gain. Total parenteral nutrition was found to be superior to gastrostomy feeding in achieving an earlier positive nitrogen balance and greater weight gain during a 4-week period. However, gastrostomy feeding is still preferred as it is cheap, simple and safe, and allows patients to be active, mobile and self dependent. Total parenteral nutrition is reserved for those patients in whom an earlier operation is advisable.
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PMID:Total parenteral nutrition versus gastrostomy in the preoperative preparation of patients with carcinoma of the oesophagus. 677 88

A patient with varicoid carcinoma of the esophagus is reported. These tumors differ from classical esophageal carcinoma and have some resemblance to esophageal varices in their radiological and endoscopic appearances. Dysphagia is generally not the presenting symptom. The histological picture in our patient was that of a poorly differentiated adenocarcinoma with areas of signet-cell carcinoma. This is an exceptional finding since all previously reported cases of varicoid carcinoma of the esophagus have been squamous cell carcinomas.
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PMID:Varicoid carcinoma of the esophagus. Report of a patient with adenocarcinoma and review of the literature. 705 96

During the past 2.5 years, 13 patients underwent esophagectomy for carcinoma of the esophagus without the use of a thoracotomy. During the same period, 81 operations on the esophagus or cardia were performed, 73 of which were esophagogastrectomies. Two patients died, for a hospital mortality rate of 2.7 percent. Of the 13 patients, there were 7 women and 6 men with an average age of 59.7 years. The lesion was located in the cervical esophagus in two, the upper thoracic esophagus in eight and the lower esophagus in three. One patient died on the 12th postoperative day, for a hospital mortality rate of 7.7 percent. Satisfactory relief of dysphagia was accomplished in all surviving patients, five of whom have died from the disease, for an average survival of 13.1 months. Seven are currently alive, with the longest period of survival 20.5 months. Esophagectomy without thoracotomy can be carried out with low mortality and morbidity rates. It is most applicable to patients with early lesions, particularly those in the cervical esophagus and the upper thoracic esophagus.
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PMID:Esophagectomy without thoracotomy for carcinoma of the esophagus. 707 13

The hitherto experience in treatment of patients with carcinoma of the oesophagus has shown that survival rates are considerably longer after resection than following the radiation therapy or palliative procedures. In our group of patients, a ratio of 16.-2:4.4 months was observed. Resection of the oesophagus with primary oesophagogastric anastomosis is the most simple method with one anastomosis only. This method was uniformly used in all our patients. Reconstruction with interposition of the colon is technically more demanding. We have utilized it in two cases only. Resection of the oesophagus and staged reconstruction are less troublesome for the patient and decrease the operative risk, but markedly prolong the entire therapeutic procedure. The technique employed in lesions involving the cardia and distal part of the oesophagus includes a left transthoracic and transdiaphragmatic approach. In higher oesophageal carcinoma, mobilization of the stomach is made through laparotomy and followed by a right transthoracic and, if need be, right transcervical resection of the oesophagus. The majority of surgeons share the view that resection of the oesophagus with a malignant lesion is potentially curative, but many of them, however, regard this procedure as affording exclusively palliation. In our series, the five-year survival rate was 21.7%. The treatment of choice should employ the simplest technique available for a radical resection and reconstruction in one stage, account for the lowest postoperative morbidity and mortality possible and afford a prompt relief of dysphagia. We also advocate a deliberate palliative resection for ist being the only palliative procedure which markedly increases the survival of patients.
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PMID:[The choice of methods and the goals of surgical treatment of carcinoma of the esophagus]. 716 7


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