Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0262471 (ENT)
 5,307 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In spite of the development of upper digestive tract fiberoptic endoscopy (FE) within the last 10 years, early detection of esophageal carcinoma (EC) is rare except in certain high-risk groups such as patients with head and neck cancers. The aim of this study was to assess the value of a meticulous histoendoscopic examination with vital toluidine blue (TB) staining in all alcohol and tobacco abusers undergoing FE for any reason except dysphagia. In 18 months, 100 patients (90 men, 10 women) who were over 40 years old and who consumed more than 80 g of alcohol and 20 g of tobacco per day underwent FE. No patient had a history of head and neck or esophageal cancer. FE was decided in 48 patients for epigastric pain, in 28 for esophageal varices, in 8 for weight loss, in 8 for anemia, in 7 for peptic disease, and in 1 for diarrhea. Staining with TB was carried out at the end of the examination and two routine biopsies were obtained 5 cm above the lower esophageal sphincter. Specimens were obtained from each abnormal area (TB + or TB -). Clinical ENT examination was recommended for all patients. Two esophageal carcinomas (1 microinvasive, 1 in situ) and 15 cases of dysplasia were detected. Dysplasia was classified as severe in 1 case, moderate in 9 cases, and mild in 5 cases.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Endoscopic detection of dysplasia and subclinical cancer of the esophagus. Results of a prospective study using toluidine blue vital staining in 100 patients with alcoholism and smoking]. 231 48

This study analyzes the respiratory complications in a retrospective study of 309 resections for esophageal cancer. We mainly performed two types of resections according to the height of the tumor: the Ivor-Lewis resection for middle thoracic lesions (182 cases), and the Akiyama resection for upper thoracic lesions (127 cases). We compared the respiratory complications occurring after these two procedures. Our overall mortality and morbidity rates were, respectively, 9% and 37%. In our series, the mortality rate was 4 times higher after the Akiyama procedure than after the Ivor-Lewis procedure, and the morbidity was twice as high. Respiratory complications accounted for 64% of the postoperative deaths. The Akiyama procedure yielded more respiratory complications, especially isolated bronchopneumonia and necrosis of the trachea or of the right or left main bronchus. Respiratory complications accounted for 53% of morbidity, mainly recurrent nerve paralysis with false passages and stasis in the transplant. Both are directly related to the surgical act and often result in bronchopneumonia. Rather than the surgical technique or the skill of the surgeon, it seems that local factors, such as the position of the tumor on the esophagus, increased the incidence of recurrent nerve paralysis following the Akiyama procedure. However, the rate of respiratory complications remained high after the Ivor-Lewis procedure. Patient history, which sometimes included a previous ENT cancer, must be taken into account, as well as the gravity of the operation and the duration of the intubation. Frequent false passages and reflux must be fought by intensive physiotherapy and, when necessary, by early tracheotomy before the patient develops postoperative acute respiratory distress syndrome.
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PMID:Respiratory complications after surgical treatment of esophageal cancer. A study of 309 patients according to the type of resection. 856 96