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Query: UMLS:C0154059 (Esophagus)
 2,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A simple technique for resection and closure of the paraesophageal hernia sac is described.
Dis Esophagus 1997 Jul
PMID:Resection of the paraesophageal hernia sac. 928 86

A case report is presented of a 59-year-old woman who was suspected of having a paraesophageal hernia, but at operation was found to have an epiphrenic diverticulum of the esophagus, a benign stromal tumor of the esophagus, and pseudoachalasia. The stromal tumor was resected laparoscopically together with a laparoscopic Heller's myotomy and partial posterior fundoplication.
Dis Esophagus 2001
PMID:Laparoscopic management of pseudoachalasia, esophageal diverticulum, and benign esophageal stromal tumor. 1142 13

There are controversies regarding existence and incidence of short esophagus. The authors reviewed the literature incidence of short esophagus among operated patients due to gastroesophageal reflux disease in the last 3 years. The overall incidence of short esophagus was 1.53%. The proposed risk factors (paraesophageal hernia, Barrett's esophagus, reoperation, esophageal strictures and access route) do have a higher incidence of short esophagus, with the exception of the Barrett's esophagus. Although several biases can be associated with the review, the authors identified the short esophagus incidence in the literature.
Dis Esophagus 2002
PMID:Short esophagus: literature incidence. 1222 Apr 19

Paraesophageal hiatal hernia is an uncommon condition that requires urgent correction to prevent life-threatening complications. It is present in 14% of all hiatal hernias. The incidence of Morgagni hernia among all diaphragmatic defects is 3-4% and about 90% of the hernias occur on the right, 8% are bilateral and 2% are on the left. The combination of a Morgagni hernia and paraesophageal hernia is very rare and only four cases have been reported in the literature. All of them occurred in the right. This report describes an old case admitted to our clinic with dyspnea, chest pain and chronic gastrointestinal symptoms, found to have combined left Morgagni and paraesophageal hernia. Surgical repair was performed via transabdominal approach. This unusual case and surgical approaches are discussed in light of the data presented in the literature.
Dis Esophagus 2003
PMID:Combination of paraesophageal hernia and Morgagni hernia in an old patient. 1282 18

Patients with iron deficiency anemia sometimes have a large paraesophageal hernia and no other explanation for their chronic blood loss. The management of these patients can be a dilemma, especially when the hernia is otherwise asymptomatic. We aimed to determine whether a laparoscopic repair of the hernia could cure the anemia. We reviewed a consecutive series of 11 cases of iron deficiency anemia associated with a large paraesophageal hernia, many without associated linear gastric erosions, managed by laparoscopic repair and fundoplication. There was one conversion in a patient with dense adhesions from previous upper abdominal surgery. Another patient required a laparoscopic reoperation for an early recurrence. Major morbidity occurred in three patients and there was no mortality. There was no recurrence of anemia after a median follow-up of more than 2 years. Iron deficiency anemia in association with a large paraesophageal hernia can be treated by laparoscopic repair with acceptable morbidity and minimal mortality. The complications of a large paraesophageal hernia are also prevented.
Dis Esophagus 2005
PMID:Effect on iron deficiency anemia of laparoscopic repair of large paraesophageal hernias. 1619 33

Rupture of the esophagogastric anastomosis is potentially lethal if untreated. We report a case of esophagogastrostomy disconnection after an upper partial gastrectomy for strangulated paraesophageal hernia. The patient, a 50-year-old woman, developed systemic sepsis due to rapid manifestation of suppurative mediastinitis followed by peritonitis and was admitted to the intensive care unit 8 days after the primary operation. The patient underwent a staged surgical treatment and survived after a prolonged hospital stay. Initial reoperation consisted of emergent laparotomy and right thoracotomy for drainage and debridement completed with excision of the anastomosis, gastric stump exclusion and subcutaneous presternal transposition of the esophagus performed through a left cervical incision. Delayed restoration of the continuity of the gastrointestinal tract was re-established using jejunum. The final result achieved was a successful esophagojejunal anastomosis with both organs transposed in a subcutaneous presternal canal. The patient regained normal swallowing function. The 'subcutaneous esophageal transposition' procedure enables the easy performance of an extrathoracic esophagojejunal anastomosis and results in a safe gastrointestinal tract reconstruction in cases with esophagogastric anastomotic leakage.
Dis Esophagus 2005
PMID:Subcutaneous esophagojejunal reconstruction in the management of esophagogastric anastomotic leak: a staged procedure. 1619 38

We examined the feasibility of trans-cutaneous electrogastrography (EGG) in recording myoelectric activity of the transposed thoracic stomach after esophagectomy. Nineteen patients who had Ivor-Lewis esophagectomy were studied. The EGG signal was recorded using cutaneous electrodes placed over the lower sternum. Eleven patients who underwent total gastrectomy served as controls. Normal rhythm pattern (2.4-3.6 cpm > or = 70%) and power ratio (PR > or = 2) was observed in five and 12 patients, respectively, after esophagectomy. The observation of normal gastric rhythm was more frequent in the postprandial period in the esophagectomy group (median 42.6%vs. 7.4%, P = 0.01), and the PR was significantly higher (median 2.27 vs. 1.38, P = 0.013) than the gastrectomy group. Feeding further increased the prevalence of normal gastric slow wave in the esophagectomy group (median 14.8% to 42.6%, P = 0.002) and improved the stability of dominant frequency (median 78% to 67%, P = 0.015). We conclude that gastric myoelectric activities of thoracic transposed stomach can be detected from cutaneous sternal electrodes. This represented a preservation of gastric motility even when the stomach is pulled up to the thorax as a substitute for the esophagus.
Dis Esophagus 2007
PMID:Trans-cutaneous electrogastrographic study of gastric myoelectric activity in transposed intrathoracic stomach after esophagectomy. 1722 14

A type IV paraesophageal hernia is a rare complication in esophageal hiatus and is an uncommon presentation of hiatal hernia. We report herein a 71-year-old man who presented with abdominal pain, nausea and constipation that was attributed to a sigmoid volvulus. At laparotomy, the sigmoid volvulus was identified as strangulated and involved in a type IV paraesophageal hernia in which the esophageal junction was located in its normal anatomic position. The esophageal hiatus was impressively dilated and there was no evidence suggesting previous mechanical disruption of the esophageal hiatus.
Dis Esophagus 2008
PMID:A type IV paraesophageal hernia containing a volvulized sigmoid colon. 1819 47

The purpose of this study is to assess the long-term outcomes after surgical repair of intrathoracic stomach. Prospectively collected data was retrospectively reviewed. Patients underwent a phone questionnaire 1 year postoperatively to assess gastroesophageal reflux disease-related symptoms and surgical satisfaction. In addition, objective evaluation for integrity of hiatal hernia repair was undertaken either by esophagram or endoscopy. Any recurrence was considered a failure. Forty-one patients underwent surgical repair of a large paraesophageal hernia with intrathoracic stomach during the study period. Thirty-four patients underwent a laparoscopic repair, and seven patients underwent a transthoracic repair. An antireflux procedure was performed on 28 patients, and 13 patients had only hernia reduction and hiatal closure. In the laparoscopic group, two patients required conversion to open laparotomy, as one was unable to tolerate the pneumoperitoneum, and the other had mediastinal bleeding. Thirty-eight (93%) were available for 1-year follow-up. There were three (7.8%) recurrences, one requiring emergency transabdominal repair, and the other two being asymptomatic 1-cm recurrences. All patients report a high degree of satisfaction with surgery. There is a high incidence of short esophagus in patients with intrathoracic stomach. The surgical repair is safe and durable, with high patient satisfaction at 1-year follow-up.
Dis Esophagus 2009
PMID:Outcomes of surgical treatment of intrathoracic stomach. 1920 56

Laparoscopic repair of paraesophageal hernia (PEH) involves removal of the hernia sac, cruroplasty, and fundoplication. Mesh application to cruroplasty seems to reduce hernia recurrence rate, but may be associated with dysphagia. The aim of the study was to review the clinical and laboratory outcomes of a series of patients with PEH after laparoscopic repair. Patients with PEH, who had laparoscopic repair and 1-year postoperative follow-up, were included in the study. Pre- and postoperative testing included symptom questionnaires, barium esophagogram, pH-monitoring, barium swallow testing. In the first half cases, suturing of large hernia gaps was reinforced with prosthesis (PR), whereas in the second half only suture cruroplasty (SC) was performed. Sixty-eight patients (36 male) with PEH were included in the study. There were no conversions to open. Postoperatively, dysphagia grading was significantly correlated to esophageal transit time (P < 0.001). There were seven recurrences; one paraesophageal and six wrap migrations. Also, four cases with stenosis were identified all in the PR group. Dysphagia was more common (P= 0.05) and esophageal transit more delayed (P= 0.034) after PR than after SC. Two revisions, one for esophageal stenosis and one for recurrent PEH, derived from the SC group. Reflux was more common after Toupet fundoplication than after Nissen fundoplication (NF) (P= 0.031) in patients with impaired esophageal motility. Laparoscopic repair of PEH with SC is associated with satisfactory clinical outcomes and low rate of wrap migration, at least similar to PR hiatal repair. NF is effective as an antireflux procedure in all cases.
Dis Esophagus 2011 Feb
PMID:Simple suture or prosthesis hiatal closure in laparoscopic repair of paraesophageal hernia: a retrospective cohort study. 2065 44


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