Search results for "Esophageal Neoplasms"

Confocal laser endomicroscopy.

2005

A miniaturized confocal microscope was developed that could be integrated in the distal tip of a conventional colonoscope. With this technique, denoted confocal endomicroscopy, subsurface analysis of the gut mucosa and in-vivo histology during ongoing endoscopy are possible in full resolution by point scanning laser analysis. The diagnostic spectrum of confocal endomicroscopy is expanding from screening and surveillance for colorectal cancer to Barrett's esophagus, Helicobacter pylori-associated gastritis, and gastric cancer. The new detailed images seen with confocal laser endomicroscopy allow a unique look on cellular structures at and below the surface of the gut. This review describes t…

C-reactive Protein Levels After Esophagectomy Are Associated With Increased Surgical Trauma and Complications.

2020

With the introduction of minimally invasive esophagectomy, postoperative complications rates have decreased. Daily laboratory tests are used to screen patients for postoperative complications. The course of inflammatory indicators after esophagectomy after different surgical approaches has not been described yet. The aim of the study was to describe the postoperative C-reactive protein (CRP) and leukocyte levels after different surgical approaches for esophagectomy and relate it to postoperative complications.Between 2010 and 2018, 217 consecutive patients underwent thoracoabdominal esophagectomy with gastric conduit reconstruction. Blood tests to assess CRP and leukocytes were performed da…

Change from Hybrid to Fully Minimally Invasive and Robotic Esophagectomy is Possible without Compromises.

2018

Background The incidence of esophageal carcinoma is increasing in the western world, and esophageal resection is the essential therapy. Several studies report advantages of minimally invasive esophagectomies (MIEs) versus conventional open procedures (OPs). The benefits of the use of fully MIE or robot-assisted MIE (RAMIE) compared with the hybrid approaches (laparoscopic gastric preparation and open transthoracic esophagectomy) remain unclear. Methods Between July 2015 and August 2017, the data of 75 patients with esophageal carcinoma were prospectively registered. Of the 75 patients, 25 treated with a hybrid MIE (hybrid), 25 with total MIE (MIE), and 25 with RAMIE. All patients were oper…

Prognostic scoring system predictive of survival after surgical resection of esophageal carcinoma.

2013

BACKGROUND The aim of our study was to develop a prognostic index score for patients undergoing surgical resection for esophageal cancer that accurately determines survival with specific clinicopathological characteristics. METHODS Clinical, histological, and demographical variables of 475 patients were entered in an univariate and multivariate regression model, followed by individual calculation of the Prognostic Indicator Score and model validation via simulation. RESULTS Significant variables included in the scoring system were number of positive lymph nodes, pT, pL, R, obesity, and American Society of Anesthesiologist classification. Survival probability and its associated hazard functi…

Risk and Complication Management in Esophageal Cancer Surgery: A Review of the Literature

2015

Esophagectomy for cancer is a highly complex and demanding two-cavity procedure associated with a considerable morbidity and mortality. There are several controversies with regard to the optimal risk and complication management. Strategies include patient selection, optimization of malnutrition, hospital and surgeon volume, intraoperative anesthesiological and surgical measures, and postoperative management of complications. In this article, we review the literature on these aspects that have an impact on outcomes after esophagectomy.

Postoperative C-reactive Protein: Focus on Patients After Esophagectomy and Clear Guidance for Daily Praxis: Reply.

2020

Novel therapeutic targets in esophageal cancer: impact of chemokine receptor CXCR4

2007

Ines Gockel†, Carl C Schimanski, Markus Moehler & Theodor Junginger †Author for correspondence Johannes GutenbergUniversity of Mainz, Department of General and Abdominal Surgery, Langenbeckstr. 1, 55131 Mainz, Germany Tel.: +49 6131 177 291; Fax: +49 6131 176 630; gockel@ach.klinik.unimainz.de ‘The interaction between esophageal cancer-expressed CXCR4 and SDF-1α may have a key role in directing malignant cells to ‘homing’ organs ... thus, this mechanism may account for metastasis.’

Helicobacter pylori and Barrett’s esophagus: a protective factor or a real cause?

2017

Nothwithstanding the definite aethiopathogenetic path of certain diseases, the relationship between Helicobacter Pylori (H. Pylori) and barrett's esophagus (BE), a condition that increases the risk for dysplasia and consequently adenocarcinoma of the distal esophagus and esophagogastric junction, remains uncertain. this paper reviews the current scientific literature with emphasis on the protective correlation between H. Pylori infection and BE, and demonstrates that a causal relathionship has not been disproved with certainty. Furthermore, H. Pylori infection could pose a risk for the onset of gastroesophageal reflux disease (GERD), which could in turn trigger BE, a precancerous lesion and…

Technical details of the hand-sewn and circular-stapled anastomosis in robot-assisted minimally invasive esophagectomy.

2020

SUMMARY The circular mechanical and hand-sewn intrathoracic anastomosis are most often used in robot-assisted minimally invasive esophagectomy (RAMIE). The aim of this study was to describe the technical details of both techniques that were pioneered in two high volume centers for RAMIE. A prospectively maintained database was used to identify patients with esophageal cancer who underwent RAMIE with intrathoracic anastomosis. The primary outcome was anastomotic leakage, which was analyzed using a moving average curve. For the hand-sewn anastomosis, video recordings were reviewed to evaluate number of sutures and distances between the anastomosis and the longitudinal staple line or gastric c…

Innovative fully robotic 4-arm Ivor Lewis esophagectomy for esophageal cancer (RAMIE4).

2019

Nowadays robotic surgery is established for abdominal and thoracic surgery. It has been shown that complex procedures are feasible using robotic systems, e.g., da Vinci Xi, with a huge benefit in precision. Different techniques for esophageal cancer surgery are reported; however, only a few robotic and partial robotic procedures are described. Therefore, a fully robotic (abdominal and thoracic) Ivor Lewis esophageal resection using four robotic arms-RAMIE4-the standard technique used for lower esophageal cancer, is presented in this paper. The technique shown in the video was performed successfully in 100 cases in 24 months. The reconstruction is performed with a gastric conduit pull-up and…