Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0022116 (ischemia)
 91,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In 26 patients with carcinoma of the esophagus or gastroesophageal junction, intestinal interposition was performed in post-resection reconstruction, using left colon in 21 cases, right colon in one and a long jejunal segment in four cases. The tumor involved the gastric cardia in 16 patients with colonic interposition and five underwent palliative resection. Infectious pulmonary and abdominal complications were common. Three patients required reoperation, for empyema, ischemic colonic segment and subphrenic abscess, respectively. Ischemia of the interposed segment occurred in two patients, necessitating removal of the segment in one. There was no anastomotic dehiscence and no tumor in the margins of the resected tissue. The 30-day postoperative mortality was 1/22 and the mean postoperative hospital stay 24 days, with 11 patients discharged directly to their homes. The functional results 6 months postoperatively were favorable in most survivors, and only three complained of dysphagia.
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PMID:Colonic interposition for reconstruction after resection of cancer in the esophagus and gastroesophageal junction. 167 28

From 1976 to 1985, 277 cases of carcinoma of the esophagus were resected in the Second Department of Surgery, Tohoku University School of Medicine. Postoperative cardiocirculatory disturbances occurred in 114 cases (41.2%), arrhythmia being the disturbance most frequently observed (86.8%). Low cardiac output syndrome occurred in 8 cases and myocardial infarction occurred in 3 cases. The majority of the cases were treated successfully, but 5 patients died within one month after operation. Causes of death were as follows: myocardial infarction, constrictive pericarditis, cardiac tamponade, non-occlusive mesenteric ischemia and acute cardiac failure. Postoperative arrhythmia occurred mainly up to the third postoperative day. Low cardiac output syndrome occurred just after operation or on the first postoperative day. All cases of myocardial infarction occurred on the first postoperative day. The rate of occurrence of cardiocirculatory disturbances in aged patients (greater than or equal to 70) was significantly higher than other group (less than or equal to 69), (56.7%:38.1%, p less than 0.05). The rate of occurrence of cardiocirculatory disturbances in patients who had a history of hypertension or in patients with abnormal preoperative electrocardiographic findings were relatively higher than those in patients who had no history of hypertension or in patients with no abnormal preoperative electrocardiographic findings. The rate of occurrence of cardiocirculatory disturbances in patients who had undergone total resection of the thoracic esophagus was significantly higher than that in patients who had undergone partial resection of the thoracic esophagus (42.8%:23.8%, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Cardiocirculatory disturbances after surgery of carcinoma of the thoracic esophagus]. 273 42

The roentgenographic and surgical experience with 44 patients treated with colon interpositions was examined. Forty-two of these patients had carcinoma of the esophagus. Staged therapy consisted of mediastinal irradiation, colonic interposition, and total esophagectomy. The more common complications related to luminal patency and conduit integrity. A total of 29.5% developed anastomotic narrowing due to postoperative edema. Anastomotic leaks arose only at the proximal anastomosis and had an incidence rate of 31.8%. Thirty-four percent had fistulous tracts originating in the reconstructed upper gastrointestinal tract. In eighty percent of the patients with leaks or fistulae, their defects healed spontaneously or with simple drainage. Strictures were encountered in 59.1%, and there were 5 instances of colonic graft ischemia. The mortality directly related to surgery was 6.8%. Ischemia, particularly at the cervical anastomosis, is probably the most common cause of complications. Radiographic evaluation is recommended using a single contrast barium examination unless gross extravasation is expected.
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PMID:Complications of colonic interposition. 400 19

One-stage operations for carcinoma of the esophagus and cardia were performed on 100 patients. The substitution of the resected esophagus was made with a isoperistaltic tube from the greater curvature of the stomach with anastomosis on the neck, in the pleural or abdominal cavities. Palliative interventions were fulfilled on 31 patients with inoperable carcinomas. An analysis of the structure and causes of postoperative complications and postoperative lethality has shown that among the most frequent causes of deaths in the postoperative period were purulent-infectious complications as a result of ischemia of gastric transplants and incompetence of sutures of the anastomoses as well as pleuro-pulmonary complications. Special attention was given to an analysis of complications after operations performed without thoracotomy from the cervico-abdominal access. The amount of postoperative complications was 30%, postoperative lethality 15%. One-year survival after operations made up 57%, 3-year survival--less than 30%, 5-year survival--less than 15%. Some recommendations are given for the surgical policy and methods of prophylactics of certain complications. Endolymphatic infusions of cytostatics used as adjuvant chemotherapy in complex treatment of patients with cardioesophageal carcinoma represent a perspective direction providing longer life of the patients without recidivations. From the oncological viewpoint the operation without thoracotomy are not always thought to be justifiable.
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PMID:[The surgical treatment of cancer of the esophagus and cardia. The complications and hazards]. 991 68

When new combinations of preoperative treatments of carcinoma of the esophagus are implemented, surgical morbidity and mortality become even more important risk factors. This study investigated whether the risk of postoperative complications caused by ischemia in the reconstructed esophagus can be reduced using microdialysis as monitoring method. This is a retrospective study of 14 patients undergoing resection of carcinoma in the upper part of the esophagus and reconstruction with a free jejunal flap. The metabolism in all 14 jejunal transfers was monitored by use of microdialysis. The data were analyzed looking for reliable parameters detecting critical ischemia. Critical ischemia was suspected in two cases. Both of these cases were surgically revised, ischemia in the jejunal flap was verified, and the jejunal flaps were revascularized. All 14 jejunal flaps survived. Using the concentration of glucose in the microdialysate, it was possible to detect the two cases of critical ischemia. Yet, the most reliable parameter seemed to be the retrospectively calculated lactate:glucose ratio; in both the ischemic flaps, the lactate:glucose ratio exceeded more than 1000% the maximum values found in all the nonischemic flaps. Microdialysis is a promising monitoring method for surveillance of free jejunal flaps.
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PMID:Free jejunal flaps can be monitored by use of microdialysis. 1866 66