RESUMEN
The palliation of patients with megaesophagus secondary to achalasia of the cardia presents significant challenges to the surgeon. Experience with palliation of megaesophagus secondary to Chagas' disease suggests that options other than cardiomyotomy or oesophagectomy can result in satisfactory outcomes. A small series of patients with non-chagasic megaesophagus who were treated with a gastroesophagoplasty procedure is discussed.
El alivio de pacientes con megaesófago secundario a la acalasia del cardias, presenta desafíos significativos al cirujano. La experiencia con la paliación del megaesófago secundario a la enfermedad de Chagas, sugiere que otras opciones distintas de la cardiomiotomía o la esofagotomía pueden producir resultados satisfactorios. Se discute una serie pequeña de pacientes con megaesófago no chagásico, que fueron tratados con un procedimiento de gastroesofagoplastia.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Acalasia del Esófago/complicaciones , Esofagoplastia/métodos , Esófago/fisiopatología , Esófago/cirugía , Gastroplastia/métodos , Unión Esofagogástrica/cirugía , Enfermedad de Chagas , Esofagectomía , Estudios Prospectivos , Fundus Gástrico/cirugía , Unión Esofagogástrica/fisiopatología , Colgajos QuirúrgicosRESUMEN
The ability to perform a hand-sutured intra-thoracic oesophago-gastric anastomosis remains an important skill for surgeons in the developing world to master. In the developed world, this skill is no longer widely practiced due to the prevalent use of surgical staplers in most centres. A simple preparation for teaching aspects of hand-sutured anastomotic techniques is described. The set-up accurately evokes the spatial relationships and restrictions encountered during the course of an intra-thoracic oesophago-gastric anastomosis, and enables trainees to gain immediate feedback regarding their progress towards mastering this important thoracic surgical skill
Asunto(s)
Humanos , Anastomosis Quirúrgica/métodos , Cirugía General/educación , Modelos Anatómicos , Competencia Clínica , Esófago/cirugía , Internado y Residencia , Técnicas de SuturaRESUMEN
A simple laboratory preparation for use in training of junior level residents in the construction of distal coronary anastomoses is described. The preparation is easily stored and rapidly set-up, and provides a realistic substrate upon which basic anastomotic technical skills can be taught and the trainee's effort can be immediately assessed