RESUMO
In the period from 2001 till 2010 there were 117 extirpations of the oesophagus with single-stage plasty of the stomach in 94 patients and plasty of the large intestine--in 23 cases. Gastric resections were performed earlier in 50 (42.7%) patients, though gastrectomy took place in 39 (78%) patients. The accumulated experience allowed making an assessment of immediate and long-term results of esophagoplasty to patients, who had earlier the gastric resection. The incompetence of oesophagogastric anastomosis was noted in 2 times more frequent and the formation of stenosis of given anastomosis in 3 times more often. I order to improve the results of esophagoplasty, the method of serousmyotomy was applied in the cases of remnant stomach.
Assuntos
Colo/transplante , Doenças do Esôfago/cirurgia , Esofagoplastia , Esôfago/cirurgia , Coto Gástrico , Estômago/transplante , Anastomose Cirúrgica/efeitos adversos , Anastomose Cirúrgica/instrumentação , Anastomose Cirúrgica/métodos , Doenças do Esôfago/classificação , Esofagoplastia/efeitos adversos , Esofagoplastia/instrumentação , Esofagoplastia/métodos , Esôfago/patologia , Feminino , Coto Gástrico/patologia , Coto Gástrico/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Estruturas Criadas Cirurgicamente/efeitos adversos , Estruturas Criadas Cirurgicamente/patologia , Resultado do TratamentoRESUMO
Video-thoracoscopic esophagectomy was performed in 51 patients including 25 patients with esophageal cancer, 18 -- with cicatricial stenosis of the esophagus and 8 -- with esophageal achalasia of stage IV. Video-thoracoscopic esophagectomy and laparotomy for gastroplasty may be performed simultaneously with 2 surgery teams that reduce time of surgery. Simultaneous thoracoscopic and transhiatal approaches to the esophagus permit avoiding conversion in severe periesophagitis.
Assuntos
Esofagectomia/métodos , Cirurgia Torácica Vídeoassistida , Adulto , Idoso , Acalasia Esofágica/cirurgia , Neoplasias Esofágicas/cirurgia , Estenose Esofágica/cirurgia , Feminino , Gastroplastia , Humanos , Laparotomia , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Resultado do TratamentoRESUMO
It is suggested that the numerous variants of diverticula occurring in the region of the major duodenal papilla should be grouped into four types. Type I--the major duodenal papilla (MDP) is on the floor of the diverticulum; type II--the MDP is in the region of the lower ++semi-circumference of the diverticular orifice while the longitudinal fold runs radially on the wall of the diverticulum; type III--the MDP is in the region of the orifice of the diverticulum while the longitudinal fold does not pass on its wall; type IV--two diverticula located above the MDP to both sides of the longitudinal fold. Endoscopic papillosphincterotomy is considered contraindicated in patients with type I diverticulum. When indicated, the intervention was carried out in patients with types III and IV diverticula. Endoscopic papillosphincterotomy can be conducted in patients with type II diverticulum measuring more than 2 cm.
