Pitfalls of esophageal surgery and their prevention:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia [u.a.]
Saunders
1997
|
| Schriftenreihe: | Chest surgery clinics of North America
7,3 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | VIII S., S. 449 - 44640 Ill., graph. Darst. |
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Datensatz im Suchindex
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| adam_text | PITFALLS OF ESOPHAGEAL SURGERY
AND THEIR PREVENTION CONTENTS
Preface xi
Stanley C. Fell and Manjit S. Bains
Cardiopulmonary Complications of Esophageal Surgery 449
David Amar
This article reviews preoperative cardiopulmonary concerns that
may need medical investigation prior to surgery. Common intra
operative hemodynamic disturbances and possible causes of res¬
piratory failure are discussed. The cardiopulmonary complica¬
tions occurring after esophagectomy reported in large series are
presented.
Pitfalls and Complications of Cricopharyngeal Myotomy 457
Denis Brouillette, Elyse Martel,
Long Qi Chen, and Andre Duranceau
Symptoms at the oropharyngeal level usually are related to misdi¬
rection of the bolus during and after deglutition and are grouped
into three categories: (1) dysphagia, which may be accompanied
by pharyngo oral regurgitations; (2) poor muscle function or con¬
trol, which may result in pharyngo nasal regurgitation; and (3)
tracheo bronchial aspiration, which appears when a lack of con¬
trol in laryngeal function is present. Cricopharyngeal myotomy
aims at improving these symptoms because they are part of the
pharyngeal phase of voluntary deglutitation. This article reviews
the pitfalls and complications of cricopharyngeal myotomy in all
categories of oropharyngeal dysphagia patients.
| CHEST SURGERY CLINICS OF NORTH AMERICA
t
VOLUME 7 • NUMBER 3 • AUGUST 1997 V
Failure After Esophagomyotomy for Esophageal Motor
Disorders: Causes, Prevention, and Management 477
F. Henry Ellis, Jr
Failures after myotomy for esophageal motor disorders can be
minimized by ensuring a correct preoperative diagnosis and by
attention to certain technical details while performing the proce¬
dure. The success rate associated with reoperative procedures is
not as good as that associated with primary operations. The best
results are achieved with take down or revision of a fundoplica
tion and antrectomy and Roux en Y diversion with or without
resection, with an improvement rate approaching 90%. Only two
thirds of patients experience improvement with fundoplication
and remyotomy.
Pitfalls and Complications of Antireflux Surgery:
Nissen and Collis Nissen Techniques 489
Mark K. Ferguson
Total fundoplication operations fail or are associated with major
complications in 15% of patients. Common problems include
incorrect patient selection, wrap disruption, gastric herniation
through the wrap, and delayed gastric emptying. A systematic
approach is outlined that helps to minimize problems with pa¬
tient selection and provides guidelines for identifying and manag¬
ing postoperative complications.
Complications and Pitfalls: Belsey and Collis Belsey
Antireflux Repairs 513
F. Griffith Pearson
This article reviews the histories and techniques of the Belsey
and Collis Belsey antireflux repair operations and discusses the
complications and pitfalls associated with these two procedures.
Pitfalls and Complications of Colon Interposition 533
Carmelo Loinaz and Nasser K. Altorki
Colon interposition is a complex operation that requires meticu¬
lous technique and attention to detail. In experienced hands,
the colon is a valuable conduit for esophageal reconstruction,
particularly in patients with benign disease.
Toxicity of Chemotherapy for Esophageal Carcinoma 551
David Ilson
The prognosis of patients with clinically locoregional esophageal
cancer is poor due to systemic recurrence of disease and a signifi¬
cant rate of local recurrence. Therefore, systemic chemotherapy
in combination with radiation therapy and surgery has been
vi CONTENTS
evaluated extensively. Recent trials suggest a trend toward im¬
proved survival with the use of combined modality therapy com¬
pared with surgery alone. Toxicity in these trials, particularly
when preoperative chemoradiotherapy is given, often is substan¬
tial and has tempered enthusiasm for the routine use of this
treatment approach. The focus of recent studies is the identifica¬
tion of more active and better tolerated systemic chemotherapy;
the drug paclitaxel in particular is a promising new agent. In the
nonsurgical, radiotherapy based treatment of esophageal cancer,
a combination of chemotherapy and radiation is superior to radio¬
therapy alone and now is standard treatment.
The Pitfalls and Complications of Radiation Therapy for
Esophageal Carcinoma 565
Janaki Moni and Dattatreyudu Nori
Radiation therapy plays a major role in the treatment of esopha¬
geal cancer. Pretreatment evaluation of the patient includes an
assessment of the extent of disease and an evaluation of the
performance status of the patient. A detailed discussion of the
radiation doses tolerated by the normal tissues surrounding the
esophagus is included, followed by a discussion of the interaction
of chemotherapeutic agents with radiation therapy. The effects of
time, dose, and fractionation are elaborated in detail. Technical
considerations affecting the efficacy of external beam radiation
therapy and brachytherapy are outlined. Pertinent literature is
discussed, and possible pitfalls in dose delivery are highlighted.
A discussion on the management of complications is included.
Complications of Abdominal Right Thoracic (Ivor Lewis)
Esophagectomy 587
Manjit S. Bains
Esophageal resection and reconstruction are associated with sig¬
nificant operative and postoperative morbidity and mortality.
Careful evaluation of the patient s cardiopulmonary status;
proper preparation of the patient with smoking cessation, exer¬
cise, and cardiopulmonary rehabilitation; assessment of the stage
of disease; selection of a suitable operative technique; and meticu¬
lous attention to technical details help reduce the incidence of
complications and ensure a successful outcome in this technically
challenging procedure.
Complications of Transhiatal Esophagectomy 601
Sanjiv K. Gandhi and Keith S. Naunheim
Transhiatal esophagectomy (THE), or esophagectomy without
thoracotomy, is a viable alternative for esophageal resection of
both benign and malignant esophageal disease. Although safety
and efficacy of this approach have been established, there are
numerous potential intraoperative and postoperative complica
CONTENTS vii
tions. Intraoperative hazards include massive mediastinal bleed¬
ing, splenic injury, recurrent laryngeal nerve damage, injury to
the tracheobronchial tree, cardiac arrhythmias, pneumothorax,
pleural effusions, and chylothorax. Postoperative complications
include various cardiorespiratory difficulties, anastomotic leaks
and strictures, and miscellaneous infectious sequelae. Despite
these risks, THE is a well tolerated operation and has become
the preferred method of esophageal resection by many thoracic
surgeons.
Pitfalls and Complications of Left
Thoracoabdominal Esophagectomy 613
Thomas J. Kirby
The left thoracoabdominal incision is an excellent option for ap¬
proaching a variety of diseases in the lower esophagus and upper
abdomen. If attention is paid to a few minor details, the incision
can be placed properly and closed with minimal morbidity as a
result of the incision itself. Routine placement of an epidural
catheter is mandatory and allows early extubation, chest physio¬
therapy, and mobilization.
Pitfalls and Complications of Esophageal Prosthesis, Laser
Therapy, and Dilation 623
Carolyn E. Reed
Although often diagnosed and treated by gastroenterologists, tho¬
racic surgeons should be skilled partners in the management of
esophageal obstruction. Knowledge of pitfalls and complications
of any procedure is a prerequisite to success. This article focuses
on problems encountered in dilatation, laser ablation, and stent
ing of esophageal strictures. Dilatation of both benign and malig¬
nant strictures requires knowledge of the different types of dila¬
tors and the ability to adapt to different stricture characteristics.
Although lower morbidity makes laser ablation of malignant
obstruction attractive, this author finds its use to be restrictive.
The advent of expandable metal stents offers the potential for
fewer early complications when compared with plastic protheses
but, as discussed, morbidity may be different rather than less.
Index 637
Subscription Information Inside back cover
Viii CONTENTS
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| physical | VIII S., S. 449 - 44640 Ill., graph. Darst. |
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| series | Chest surgery clinics of North America |
| series2 | Chest surgery clinics of North America |
| spelling | Pitfalls of esophageal surgery and their prevention Stanley C. Fell, guest ed. Philadelphia [u.a.] Saunders 1997 VIII S., S. 449 - 44640 Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Chest surgery clinics of North America 7,3 Chirurgie (DE-588)4009987-8 gnd rswk-swf Komplikation (DE-588)4123547-2 gnd rswk-swf Speiseröhrenkrankheit (DE-588)4182156-7 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Speiseröhrenkrankheit (DE-588)4182156-7 s Chirurgie (DE-588)4009987-8 s Komplikation (DE-588)4123547-2 s DE-604 Fell, Stanley C. Sonstige oth Chest surgery clinics of North America 7,3 (DE-604)BV005455558 7,3 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=007722942&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Pitfalls of esophageal surgery and their prevention Chest surgery clinics of North America Chirurgie (DE-588)4009987-8 gnd Komplikation (DE-588)4123547-2 gnd Speiseröhrenkrankheit (DE-588)4182156-7 gnd |
| subject_GND | (DE-588)4009987-8 (DE-588)4123547-2 (DE-588)4182156-7 (DE-588)4143413-4 |
| title | Pitfalls of esophageal surgery and their prevention |
| title_auth | Pitfalls of esophageal surgery and their prevention |
| title_exact_search | Pitfalls of esophageal surgery and their prevention |
| title_full | Pitfalls of esophageal surgery and their prevention Stanley C. Fell, guest ed. |
| title_fullStr | Pitfalls of esophageal surgery and their prevention Stanley C. Fell, guest ed. |
| title_full_unstemmed | Pitfalls of esophageal surgery and their prevention Stanley C. Fell, guest ed. |
| title_short | Pitfalls of esophageal surgery and their prevention |
| title_sort | pitfalls of esophageal surgery and their prevention |
| topic | Chirurgie (DE-588)4009987-8 gnd Komplikation (DE-588)4123547-2 gnd Speiseröhrenkrankheit (DE-588)4182156-7 gnd |
| topic_facet | Chirurgie Komplikation Speiseröhrenkrankheit Aufsatzsammlung |
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