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Background Diagnosis of gastro-esophageal reflux disease (GERD) is mainly based on symptom evaluation, possibly coupled with various invasive investigations (endoscopy, pH-metry, and impedance). New input has recently come from histology: in this context, the diagnostic role of inflammatory cells other than eosinophils and neutrophils is still debated. Aim of the study is to evaluate the diagnostic...
Malignant melanoma is a rare tumor that commonly occurs in the skin; however, it can also develop in other sites, including the esophagus, oral cavity, sinonasal tract, anorectal region, vagina, and eye. Esophageal primary malignant melanoma (EPMM) accounts for approximately 0.2–0.3 % of all malignant esophageal tumors. The mean age of patients who develop EPMM is 61 years (range 21–90 years). EPMM...
Background The incidence of anastomotic stenosis ranges from 26 to 42 % in patients who have undergone esophagectomy. Stenosis reduces patient quality of life and requires multiple endoscopic balloon dilations (EBDs). We investigated the effects of EBD with intralesional steroid injection on anastomotic re-stenosis after EBD. Methods We retrospectively analyzed 30 esophageal cancer patients who...
Esophagus is an important part of the alimentary canal that performs various functions, most important of which is the transfer of bolus from the pharynx to the stomach. This involves active contraction of both the circular and longitudinal esophageal muscles. Esophageal anatomical features are harmonized with the functional and physiological demands of esophagus. However, impairment of esophageal...
Background Basaloid squamous cell carcinoma (BSCC) is a relatively rare, malignant disease of the esophagus. The prognosis of patients with BSCC is thought to be poorer than that of typical squamous cell carcinoma (SCC), but the treatment strategy for BSCC is generally the same as that for typical SCC. This study examined the diagnosis, the clinical and pathological characteristics, and the results...
Right non-recurrent inferior laryngeal nerve is a rare nerve anomaly that communicates the right vagal nerve trunk to the laryngeal nerve directly in the neck, and is usually accompanied by an aberrant right subclavian artery. We report a case of thoracic esophagectomy with intraoperative neuromonitoring undertaken in a patient with these abnormalities. This case report concerns a 66-year-old man...
Background The extent of node dissection in esophageal cancer surgery is usually estimated by the number of resected nodes, irrespective of the area of dissection. The efficacy of lymph node dissection by area was evaluated according to the location of the primary tumor. Methods The study group comprised the 3827 patients who underwent R0 esophagectomy with three-field lymph node dissection for...
Acquired esophago-respiratory fistulae are usually esophago-tracheal or esophago-bronchial. Esophago-pulmonary fistulae have been rarely described. We report a case of 17-year-old girl with esophago-pulmonary fistula. She experienced a long history of cough and expectoration. CT scans of the chest demonstrated right lower and middle lung lobes multiple cavitary lesions with marked dilatation of the...
Background We previously reported that the expression of fibroblast growth factor receptor-like 1 (FGFRL1) was associated with the progression of esophageal squamous cell carcinoma (ESCC). However, the clinical roles of FGFR1, FGFR2, FGFR3, and FGFR4 in ESCC have not yet been examined in detail. Furthermore, it currently remains unclear why FGFRL1 is a prognostic factor for ESCC. Materials and methods...
Background We conducted paravertebral block (PVB) for thoracotomy, with epidural anesthesia carried out as usual for laparotomy. To date, there has been no report of combining continuous PVB for thoracotomy and epidural anesthesia for laparotomy after esophagectomy. The aim of this historical study was to evaluate the efficacy of the combination. Methods This is a retrospective analysis of 105 patients...
Background and aim Identification of the esophageal gastric junction (EGJ) is of crucial importance for the consistent detection of Barrett’s esophagus (BE). In Japan, the distal end of the lower esophageal palisade vessels is used to define the EGJ. However, in Western countries, the EGJ is defined as the proximal margin of the gastric folds. In this prospective study, we compared the variation in...
Diaphragmatic herniation after esophagectomy for carcinoma of the esophagus is a rare postoperative complication. Several recent reports reveal that minimally invasive esophagectomy (MIE) with mediastinal reconstruction is associated with a higher incidence of herniation compared with open esophagectomy. Thoracolaparoscopic esophagectomy (TLE), also called “total MIE”, results in fewer peritoneal...
Background Recent improvements in the survival of patients after esophagectomy have led to an increasing occurrence of gastric cancer in the reconstructed gastric tube (GTC). The aim of this study was to assess generational changes in the clinicopathological characteristics and treatment of GTCs in a single center. Methods Thirteen GTC lesions in ten patients were diagnosed and treated at Keio University...
Objectives In patients with obstructive esophageal cancer (OEC) with stenosis of the tract to the stomach, the percutaneous endoscopic gastrostomy (PEG) procedure cannot be performed if the endoscope is unable to pass through to the stomach. Our aim was to describe the safety and utility of the gradual tube dilation method (GTD) before PEG in cases of OEC. Methods This study enrolled 38 consecutive...
Objectives Multiple factors including genetic and environmental factors play a role in the pathogenesis of gastroesophageal reflux disease (GERD). The objective of this study was to quantitatively evaluate the association between Interleukin-1B-511 gene polymorphism and GERD susceptibility. Methodology Medline, CBM, VIP, CNKI, and Wanfang database were searched up to July 2014. Two reviewers independently...
Background In spite of appropriate preparation, food residue that interferes with endoscopic examination is occasionally observed in an operated stomach. The present study aimed to elucidate the incidence of such food residue and determine its risk factors in gastric pull-up after esophagectomy. Methods A total of 116 esophagectomized patients underwent the first postoperative endoscopy to survey...
Tracheobronchial fistulae after esophagectomy are rare but critical complications because they frequently cause severe pneumonia. In three cases with esophageal cancer, we used the latissimus dorsi muscle after esophagectomy to reinforce the fragile tracheobronchus. In cases 1 and 2 with gastric tube-to-tracheal fistula, the gastric tube was pulled out from the posterior mediastinum, the fistula was...
Background Use of an endocytoscopy system (ECS) makes it possible to omit biopsy histology for esophageal squamous cell carcinoma (ESCC). However, for differential diagnosis of ESCC, the endocytoscopic characteristics of esophagitis should be clarified. Methods We examined the morphology of surface cells in 20 cases of gastroesophageal reflux disease (GERD) (Grade M: 6 cases, A: 5 cases, B: 1 cases,...
Complications of surgery for gastro-oesophageal reflux disease can provoke severe symptoms that condemn the patient to a very poor quality of life. A similar clinical picture is presented among patients with lactase deficiency, which is highly prevalent today. In view of these considerations, we consider to what extent lactase deficiency may influence the symptoms observed following gastro-oesophageal...
Background Benign esophageal strictures are common among children, especially children under 5 years of age. There is no standard treatment for refractory benign esophageal stricture, and it is quite challenging to care for children. The aim of this research is to establish an animal model of benign esophageal stricture with a custom balloon catheter, offering a cornerstone for exploring effective...
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