Cases reported "Esophageal Neoplasms"

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11/140. Two cases of benign tracheo-gastric fistula following esophagectomy for cancer.

    Two successfully managed cases of esophageal replacement for cancer complicated by neoesophagotracheal fistula are described. In both cases radical esophagectomy with a gastric pull-up was performed. In the postoperative period different complications necessitated prolonged ventilatory support and tracheostomy. In both cases a tracheo-gastric fistula developed probably because of the ischaemic effort of the tracheostomy tube and the nasogastric tube. At single stage repairs, the fistulae were divided and the gastric defects were closed directly. In the first case resection of four strictured tracheal rings and tracheal anastomosis had to be performed. In the second case the fistula was recognized earlier and stricture did not develop. The defect on the membranous trachea was patched with autologous fascia lata graft. A left pectoralis major muscle flap was interposed between the trachea and the pulled up stomach in both cases to prevent recurrence of the fistula. Treatment of this potentially life-threatening and rare condition yielded excellent results.
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12/140. Non-malignant tracheo-gastric fistula following esophagectomy for cancer.

    Two cases of neoesophago-tracheal fistula are described. After esophagectomy for cancer a fistula developed between the trachea and the pulled-up stomach probably because of the ischaemic effect of the tracheostomy tube. At single stage repairs, the fistulae were divided and the gastric defects were closed directly. In one case, tracheal resection and anastomosis was necessary. The defect on the membranous trachea in both cases was patched with an autologous fascia lata graft. A left pectoralis major muscle flap was interposed between the suture lines to prevent recurrence of the fistula. Treatment of this potentially life-threatening and rare condition yielded excellent results.
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ranking = 0.88888888888889
keywords = fistula
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13/140. Malignant laryngotracheal obstruction: a way to treat serial stenoses of the upper airways.

    BACKGROUND: Six patients known to have inoperable esophageal carcinoma presented with stridor due to both malignant tracheal stenosis (n = 6) and bilateral vocal cord paralysis. Two patients also had respiratory-digestive fistula. methods: Patency was restored by endotracheal stenting plus unilateral cordectomy. Four patients had immediate relief. Two patients required enlargement of the cord incision. One of them declined reoperation and underwent tracheotomy. RESULTS: Stent function was uneventful. There was no dislodgement or mucous impaction. Fistula seal was complete. There was no aspiration through the new-shaped glottic orifice. Peak expiratory flow increased from 24.4% /- 9.7% predicted normal before to 40.5% /- 13.7% after the procedure, whereas the dyspnea score decreased from 74.2 /- 12.7 to 24.2 /- 14.0. CONCLUSIONS: Restoration of airway continuity in serial laryngotracheal stenoses using a combined approach is a feasible technique in end-stage cancer patients. It effectively relieves respiratory distress and ensures voice preservation. In addition, it may avoid the risks of tracheotomy.
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keywords = fistula
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14/140. A rare complication of surgical management for esophageal tumor: a non neoplastic belated fistula between stomach and main right bronchus.

    The fistula between stomach and bronchus after surgery for cancer of the esophagus is a rare occurrence. We describe a gastric non neoplastic ulceration that arose late after six years from an esophagectomy, with an end-side cervical esophagogastrostomy, for a spino-cellular carcinoma. After the partial failure of surgical technique, of the endoscopic treatment and for the bad general conditions of patient we decided to treat the fistula by transluminal drainage. This technique involved a progressive resolution of the fistula, becoming, nowadays, in our division, the preferred treatment for these kinds of postoperative complications.
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ranking = 0.77777777777778
keywords = fistula
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15/140. Clinical experiences of stenting in patients with esophago-bronchial fistula: report of four cases.

    The esophagorespiratory fistula is difficult to treat, and the patients' quality of life is generally poor due to suffering from dysphagia and dyspnea. We performed stent therapy in four cases of the esophagorespiratory fistula associated with esophageal cancer. Three of four patients showed improved symptoms, enabling oral liquid or food intake, although one died of dyspnea despite the therapy. The findings suggest that stent therapy is an effective method to close the esophagorespiratory fistula and to improve the patients' quality of life, although it is temporary and not a radical treatment.
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ranking = 0.77777777777778
keywords = fistula
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16/140. Primary aorto-oesophageal fistula due to oesophageal carcinoma. Report of a successfully managed case.

    Aorto-oesophageal fistula is a rare but often fatal entity causing upper gastrointestinal bleeding. Amongst the different aetiologies described, the commonest is rupture of a thoracic aortic aneurysm into the oesophagus. This entity was first reported in 1818, and only recently have successfully treated cases been published. Other causes such as postoperative complications, tuberculosis and trauma are less common. Oesophageal malignancy perforating the aorta is a rarity. The authors describe a case of aortic perforation secondary to an oesophageal carcinoma, treated with initial success. The clinical onset was a massive upper gastrointestinal haemorrhage. The diagnosis, once the bleeding was controlled, was arrived at after CT-scanning and arteriography. A Dacron prosthesis was interposed into the descending thoracic aorta to restore aortic flow; later an oesophagectomy plus oesophagostomy and jejunostomy were carried out.
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keywords = fistula
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17/140. Esophageal squamous cell carcinoma 38 years after primary repair of esophageal atresia.

    The authors report a case of a 38-year-old man with an esophageal squamous cell carcinoma after repair of esophageal atresia with tracheoesophageal fistula. This carcinoma occurred at a young age, near to the scar of the old anastomosis, in a patient with no other apparent risk factors. It is hypothesized that stasis caused by impaired esophageal motility may be the underlying cause. A single case is not enough to unequivocally prove a possible relationship between esophageal atresia and the development of esophageal cancer. Now that the first generation of survivors of esophageal atresia is reaching middle aged adulthood, one should, however, be aware of a possible increased incidence in these patients. J Pediatr Surg 36:629-630.
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keywords = fistula
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18/140. Toxicity of photodynamic therapy after combined external beam radiotherapy and intraluminal brachytherapy for carcinoma of the upper aerodigestive tract.

    BACKGROUND AND OBJECTIVE: To describe the toxicity of photodynamic therapy (PDT) in patients with carcinoma of the upper aerodigestive tract who received prior treatment with external beam irradiation and intraluminal brachytherapy (IB). STUDY DESIGN/MATERIALS AND methods: hospital records of PDT patients were reviewed. Three patients who received prior treatment with external beam irradiation and IB were identified. Two patients had esophageal carcinoma treated with combined chemotherapy and external beam irradiation (55.8 and 50.4 Gy) followed by IB (12 Gy and 35 Gy at 1 cm). These patients then received PDT for treatment of recurrence (2 mg/kg Photofrin injection and 2 light applications: 630 nm, 150--200 J/cm, 200--400 mW/cm). One patient had non-small cell lung cancer treated with external beam irradiation (60 Gy) followed by IB (36.1 Gy at 1 cm) and then received PDT for recurrence (1 mg/kg Photofrin injection and one light application: 630 nm, 150 J/cm, 200 mW/cm). RESULTS: One patient with esophagus cancer had formation of a tracheoesophageal fistula, which required stent placement. The other esophageal cancer patient developed quadriplegia due to an epidural abscess arising from a fistula with the diseased portion of the esophagus. The lung cancer patient had massive hemoptysis after the procedure and died 2 days later. autopsy showed necrotizing arteritis of the right pulmonary artery. CONCLUSION: patients with upper aerodigestive tract carcinoma who have received treatment with both external beam irradiation and IB seem to be at higher risk for complications when treated with PDT.
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ranking = 0.22222222222222
keywords = fistula
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19/140. Concurrent glottic and tracheal stenoses: restoration of airway continuity in end-stage malignant disease.

    Six patients known to have inoperable esophageal carcinoma presented with stridor due to both malignant tracheal stenosis (with additional respiratory-digestive tract fistula in 2 patients) and bilateral vocal cord paralysis. Patency was restored by endotracheal stenting plus unilateral cordotomy. Four patients had immediate relief. Two patients required enlargement of the vocal cord incision. One of them declined reoperation and underwent tracheostomy. The stent function was uneventful, with no dislodgment or mucus impaction. The fistula seal was complete, with no aspiration through the newly shaped glottic orifice. The peak expiratory flow increased from 24.4% /- 9.7% of predicted normal before the procedure to 40.5% /- 13.7% after the procedure. Restoration of airway continuity in serial laryngotracheal stenoses by a combined approach is a feasible technique in end-stage cancer patients. It effectively relieves respiratory distress and ensures voice preservation. In addition, it may avoid the risks of tracheotomy.
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ranking = 0.22222222222222
keywords = fistula
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20/140. Epiphrenic diverticula, esophageal carcinoma and esophagopleural fistula.

    A case report of a patient with two epiphrenic diverticula and a squamous cell carcinoma within one of them is presented. Moreover, a pleural empyema and an esophagopleural fistula appeared following the neoplasic diverticulum perforation. Only a few cases have been previously described in the English-language literature. An additional one is now presented.
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ranking = 0.55555555555556
keywords = fistula
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