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

Clinical decision-making in esophageal cancer surgery is a process of balancing the risks of treatment against potential benefits, such as survival and quality of life. Various options are available for esophageal reconstruction. While these reconstructive options do not directly have an impact on cancer survival, they do affect operative morbidity and long-term quality of life. The affect of various interponats (reconstructive conduits) and routes of reconstruction on operative morbidity and foregut function is reviewed. Gastric interponats are preferred for esophageal reconstruction because of their reliable vascularity and the relative simplicity of the reconstructive operation. Colon interponats supposedly provide better long-term function as an esophageal substitute (unproven), but at the cost of increased operative complexity and morbidity. Colon interposition is therefore reserved for situations in which gastric transposition is not feasible. Both posterior and anterior mediastinal routes of gastric interponat reconstruction are acceptable (meta-analysis of randomized controlled trials). Posterior mediastinal reconstruction is usually preferred when a complete (R0) resection has been accomplished. Anterior mediastinal reconstruction may prevent secondary dysphagia after incomplete (R1, R2) resections.
Dis Esophagus 2001
PMID:Does the interponat affect outcome after esophagectomy for cancer? 1155 22

Hiatoplasty is generally considered an essential part of antireflux operations. Posterior closure of an enlarged hiatus may lead to anterior displacement of the esophagus and it may be contributory to postoperative dysphagia. The aims of this study were to (i) measure the normal esophageal anteroposterior angulation, (ii) evaluate the variation of the angulation after laparoscopic hiatoplasty and fundoplication, and (iii) correlate the angulation with postoperative dysphagia. Normal esophageal anteroposterior angle determined by barium preoperative barium esophagram was evaluated based on the study of 100 patients. Postoperative angulation was evaluated based on the study of 32 patients who underwent barium esophagram after laparoscopic hiatoplasty and fundoplication. The results showed that the normal esophageal anteroposterior angle was 150.4 +/- 10.7 (range 119-169) degrees. There was no correlation between the angle and gender (P = 0.6) or age (P = 0.1). Postoperative angle averaged 146.6 +/- 11.7 (range 122-170) degrees. Normal and post-operative angle were not different (P = 0.1). The difference between post- and preoperative angle averaged 0.7 +/- 8.9 (range -15-14). There was no statistically significant difference when pre- and post-operative angles were compared (P = 0.6). De novo dysphagia was present in 31% of the 32 postoperative patients. There was no statistically significant difference when the angles in patients with and without de novo dysphagia were compared (P = 0.2). We concluded that (i) laparoscopic hiatoplasty and fundoplication does not significantly change the esophageal anteroposterior angle; and (ii) de novo dysphagia is not with the esophageal anteroposterior angle.
Dis Esophagus 2009
PMID:Esophageal angulation after hiatoplasty and fundoplication: a cause of dysphagia? 1901 48