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@#The esophageal disease is a major clinical disease. The esophageal stent has extensive clinical applications in the treatment of esophageal diseases. However, the clinical application of esophageal stent is limited, because there are lots of complications after implantation of esophageal stent. Biodegradable esophageal stent has two advantages: biodegradability and good histocompatibility. It is expected to solve a variety of complications of esophageal stent and provide a new choice for the treatment of esophageal diseases. Standardized esophageal stents are not fully applicable to all patients. The application of 3D printing technology in the manufacture of biodegradable esophageal stent can realize the individualized treatment of esophageal stent. And meanwhile, the 3D printing technology can reduce the manufacturing cost of the stent. This review aimed to summarize and discuss the application of esophageal stent, the current research status and prospect of biodegradable esophageal stent and the prospect of 3D printing technology in degradable esophageal stent, hoping to provide evidence and perspectives for the research of biodegradable esophageal stent.
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Objective@#To evaluate the safety and effectiveness of esophageal replacement with ileocolon graft.@*Methods@#Totally 34 cases of esophageal replacement with ileocolon graft from July 2015 to November 2017 at Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiaotong University were analyzed retrospectively, including 24 male and 10 female, aging from 7 to 72 years old. Esophageal replacement with ileocolon graft by right and/or middle colic artery as a blood supply using retrosternal route except one subcutaneous route. The primary esophageal disease, postoperative complication rate and quality of life were analyzed.@*Results@#The overall postoperative complication rate was 23.5% (8/34), cervical anastomotic leakage rate of 5.9% (2/34), necrosis of colon graft of 5.9% (2/34). There were 3 patients experienced re-operation including 2 patients with colon graft necrosis and 1 patient with intestinal obstruction after ERC. One patient with colon graft necrosis died of septic shock after reoperation. Six cases of cervical esophago-jejunal anastomosis stenosis and 1 case of diarrhea occurred in the later time. All patients were followed up for a median time of 9 months (range: 1 to 28 months), 32 cases survived but 1 patient died until last follow-up by the end of December 2017.@*Conclusion@#Esophageal replacement with ileocolon graft by right and/or middle colic artery as a blood supply using retrosternal route was safe and effective.
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The growth rate of the incidence of Barrett's esophagus ranked the second place among all the malignant esophageal tumors,and Barrett's esophagus is a precursor of esophageal adenocarcinoma.The incidence of Barrett's esophagus is closely related to social economic status.In developed countries,the incidence of esophageal adenocarcinoma associared with Barrett's esophagus has been increased rapidly.The risk factors for Barrett's esophagus include gastroesophageal reflux disease,white or Hispanic race,male,age,smoking and obesity.The treatment of Barrett's esophagus mainly include drug therapy,endoscopic therapy and surgical treatment.The efficiency of chemoprevention of Barrett's esophagus still needs to be proved by further randomized clinical trials.
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Killian-Jamieson diverticulum is a rare diverticular disease. This disease differs from Zenker's diverticulum in its location and mechanism. Various treatment modality have been attempted, but traditional surgical treatment has been recommended for a symptomatic Killian-Jamieson diverticulum due to the concern of possible nerve injury. We performed surgical treatment by cervical incision. We report here on a case of Killian-Jamieson diverticulum and we briefly review the relevant literature.
Subject(s)
Diverticulum , Esophageal Diseases , Zenker DiverticulumABSTRACT
The incidence of gastrointestinal complications has increased as endoscopic biopsy has become a standard diagnostic technique. However, esophageal dissection is a rare complication. A 71-year-old man suffered retrosternal pain for 15 days. Fifteen days previously, he had undergone an endoscopic gastrointestinal examination at a local clinic and an esophageal biopsy to obtain microscopic confirmation of esophageal candidiasis. The patient then underwent a subsequent endoscopic examination, which showed features specific to esophageal submucosal dissection. The predisposing conditions for esophageal dissection are coagulopathy, iatrogenic trauma (variceal sclerotherapy), drugs (thrombolytic agents, aspirin), foreign bodies/certain foods (fish, chicken bones), and emesis. However, endoscopic biopsy is a rare predisposing condition. Here, we report a case of esophageal submucosal dissection that developed after esophageal biopsy. We observed the healing process of this lesion with a series of endoscopies as part of a conservative treatment plan.
Subject(s)
Aged , Humans , Biopsy , Candidiasis , Chickens , Endoscopy , Esophageal Diseases , Incidence , VomitingABSTRACT
The incidence of gastrointestinal complications has increased as endoscopic biopsy has become a standard diagnostic technique. However, esophageal dissection is a rare complication. A 71-year-old man suffered retrosternal pain for 15 days. Fifteen days previously, he had undergone an endoscopic gastrointestinal examination at a local clinic and an esophageal biopsy to obtain microscopic confirmation of esophageal candidiasis. The patient then underwent a subsequent endoscopic examination, which showed features specific to esophageal submucosal dissection. The predisposing conditions for esophageal dissection are coagulopathy, iatrogenic trauma (variceal sclerotherapy), drugs (thrombolytic agents, aspirin), foreign bodies/certain foods (fish, chicken bones), and emesis. However, endoscopic biopsy is a rare predisposing condition. Here, we report a case of esophageal submucosal dissection that developed after esophageal biopsy. We observed the healing process of this lesion with a series of endoscopies as part of a conservative treatment plan.
Subject(s)
Aged , Humans , Biopsy , Candidiasis , Chickens , Endoscopy , Esophageal Diseases , Incidence , VomitingABSTRACT
Killian-Jamieson diverticulum is a rare disease that is seen at the cervical esophagus. It has quite a different pathogenesis and anatomical location compared with that of Zenker's diverticulum. The pathophysiology and strategy for treating Killian-Jamieson diverticulum are not fully understood. We performed surgery using one incision for treating a case of Killian-Jamieson diverticulum and we review the medical literature that's related to this unusual diverticulum.
Subject(s)
Diverticulum , Diverticulum, Esophageal , Esophageal Diseases , Esophagus , Rare Diseases , Zenker DiverticulumABSTRACT
Acquired bronchoesophageal fistula rare. Conservative treatment such as endoscopy is widely used. The recurrence rate after endoscopic treatment, however, is not well known. We report here on a case of a 54-year-old female who presented with recurrent bronchoesophageal fistula after endoscopic treatment that filled the fistula tract with Histoacryl(R).
Subject(s)
Female , Humans , Middle Aged , Endoscopy , Esophageal Diseases , Fistula , RecurrenceABSTRACT
Esophageal perforation is relatively uncommon but it often cause fatal if not properly treated, and it is associated with high morbidity and mortality. We report here on two cases of esophageal perforation caused by Boerhaave syndrome or pneumatic dilatation for treating achalasia. The patients were successfully treated with thoracoscopic primary repair and esophagomyotomy.
Subject(s)
Humans , Dilatation , Esophageal Achalasia , Esophageal Diseases , Esophageal Perforation , Mortality , ThoracoscopyABSTRACT
Intramural dissection of the esophagus is rare esophageal disorder which has been seen predominantly in women in their seventh or eighth decade and presents as acute chest pain, accompanied by dysphagia. The etiology of this disorder remain uncertain and the diagnosis is made by esophageal endoscopy, contrast esophagography, or both. Patient with this disorder is best managed conservatively with nothing by mouth and intravenous hydration.
Subject(s)
Female , Humans , Middle Aged , Chest Pain , Deglutition Disorders , Diagnosis , Endoscopy , Esophageal Diseases , Esophagus , MouthABSTRACT
Bronchogenic cysts are anomalous cystic lesions of foregut and usually located in the lung or mediastinum. Generally intramuscular cysts of the esophagus are considered as enterogenous foregut malformations. We report a young adult with an intramural bronchogenic cyst causing dysphagia and heartburn. It was located in the muscular layer of the esophagus and was removed without any damage to the mucosa. Histopathologic findings revealed that it was a bronchogenic cyst.
Subject(s)
Humans , Young Adult , Bronchogenic Cyst , Deglutition Disorders , Esophageal Diseases , Esophagus , Heartburn , Lung , Mediastinum , Mucous MembraneABSTRACT
An 18-year old woman had dysphagia and frequent vomiting after meals for 6 years. She lost 15 kg in 6 months recently. After esophageal manometry, she was diagnosed with achalasia. We decided to use laparoscopic surgery because there was no symptomatic improvement after medication. We made small 5 incisions on her abdomen. We performed Heller myotomy and Dor fundoplication. We performed esophagogram one day after the operation. There was no leakage of the contrast media, and it passed well. She started to eat at the 2nd day after the operation and was discharged on the 9th day without other specific problem.
Subject(s)
Adolescent , Female , Humans , Abdomen , Contrast Media , Deglutition Disorders , Esophageal Achalasia , Esophageal Diseases , Fundoplication , Laparoscopes , Laparoscopy , Manometry , Meals , Minimally Invasive Surgical Procedures , VomitingABSTRACT
BACKGROUND: The use of the stapler n esophageal reconstruction after esophageal resection for benign or malignant esophageal diseases has become popular because it has less leakage at the anastomotic site and shorter operation time than manual sutures. However, the use of classic circular stapler has some complications such as stenosis and dysphagia that requires additional treatment. Such complications are closely related to the inner diameter of the anastomotic sites. In this study, the diameter of anastomotic site was compared after the use of circular stapler(EEA) and straight endoscopic stapler(endo GIA). MATERIAL AND METHOD: The patients who received esophageal reconstruction by stapler from August 1995 to September 1997 were reviewed. The patients were divided into 2 groups. One group need the circular stapler, and the other group the straight endo GIA(14 cases with endo GIA 30mm, 24 with endo GIA 45mm). After a cervical esophago-enteric anastomosis, the stricture of anastomotic site and the incidence of dysphagia were compared between the 2 groups using an esophagography and the patient's symptoms. The follow-up period was 12months in average. RESULT: In the former group in which the circular stapler was used, 2 cases of anastomotic stenosis were reported. In comparison, none were reported in the latter group. Dysphagia were reported in 8 cases of the former group, and in 3 cases of the latter group(1 case in endo GIA 30 mm, 2 cases in endo GIA 45 mm). CONCLUSION: The use of endo GIA in esophago-enteric anastomosis resulted in a wider diameter of the anastomotic site, lesser stricture, and lesser incidence of dysphagia compared to the use of former circular stapler. Therefore, it is thought to be a better method in esophageal reconstructions.
Subject(s)
Humans , Constriction, Pathologic , Deglutition Disorders , Esophageal Diseases , Follow-Up Studies , Incidence , Surgical Staplers , SuturesABSTRACT
BACKGROUND: Benign esophageal diseases are less common indications for an esophagectomy. The indications for an esophagectomy have not been clearly defined for benign esophageal diseases. The purpose of this study was to defermine whether an esophagectomy should be performed for benign esophageal disease and the indications for an esophagectomy. METHODS: The postoperative morbidity and mortality were examined in 11 patients who had received esophagectomy and esophageal reconstruction for benign esophageal diseases between 1981 and 1996 in this hospital. The indications were identified. RESULTS: The indications included corrosive stricture (6 cases), recurrent achalasia (2 cases), accidental esophageal perforation (1 case), a esophageal diverticulum with stricture (1 case) and suspicion of malignancy (1 case). All of the patients with recurrent achalasia had undergone at least one prior esophageal operation, and all of the patients with stricture had had at least one esophageal dilation previouly. There was no postoperative mortality after the esohagectomies. Postoperative complications developed in 7 patients. Early complications were anastomotic leakage (3 cases), bronchopneumonia (1 case) and DIC & ARDS (1 case). Later complications were intestinal obstruction (1 case), anastomotic bleeding (1 case) and anastomotic stenosis (4 cases) which needed one or two dilation procedures to improve the symptoms. CONCLUSION: Although an esophagectomy for benign esophageal diseases resulted in high morbidity, there were no mortalities. Thus, an esophagectomy should be considered for benign conditions of the esophagus because of corrosive cancer and the end-stage of motility disorders.
Subject(s)
Humans , Anastomotic Leak , Bronchopneumonia , Constriction, Pathologic , Dacarbazine , Diverticulum, Esophageal , Esophageal Achalasia , Esophageal Diseases , Esophageal Perforation , Esophagectomy , Esophagus , Hemorrhage , Intestinal Obstruction , Mortality , Postoperative ComplicationsABSTRACT
Two cases of bleeding by rupture of esophageal varices due to portal hypertension treated by sect-anastomosis by using EEA with good result was presented. With the simplicity of technique, the author hopes that technique will be applied to the severe condition of the patients.
Subject(s)
Sclerotherapy , Esophageal and Gastric VaricesABSTRACT
Many esophageal diseases need esophageal replacement. Replacement with autograft leads to great damage and complications. The existing artificial esophagus, however, cannot match the demands of esophageal replacement. The study of tissue-engineered esophagus is the hope to solve these problems. This article reviews the progression of tissue-engineered esophagus.