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  • 1985-1989  (4)
  • Transthoracic esophagectomy  (2)
  • Barrett's esophagus  (1)
  • Fundoplication
  • 1
    Electronic Resource
    Electronic Resource
    Treatment of dysphagia in esophageal carcinoma: Transthoracic En-Bloc esophagectomy and reconstruction 48 hours later (1988)
    Springer
    Dysphagia 2 (1988), S. 222-227 
    Details
    ISSN: 1432-0460
    Keywords: Esophageal cancer ; Transthoracic esophagectomy ; Mediastinal lymphadenectomy ; Delayed reconstruction ; Blunt esophageal dissection
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In 82 consecutive patients with esophageal cancer (90% squamous cell carcinoma, 10% adenocarcinoma) transthoracic “en bloc” esophagotomy with regional lymphadenectomy was performed. The reconstruction with gastric interposition was carried out with delayed urgency in a second operation 48–72 h after the initial procedure. The results of this group were compared to a group of 65 patients who had transmediastinal esophagectomy without thoractotomy and mediastinal as well as suprapancreatic lymphadenectomy and immediate reconstruction by gastric interposition. The number of postoperative risk situations concerning cardiopulmonary features were comparable in both groups. The 30-day mortality rate and postoperative morbidity was not significantly different between both patient groups (mortality rate: transthoracic: 6.6%, transmediastinal: 7.7%). The advantages of a 2-stage procedure are that esophagectomy and especially mediastinal lymphadenectomy can be performed precisely without time pressure. After 2 days the stomach is hypotonic and dilated as a result of truncal vagotomy and can easily be elevated to the neck. The interval of 48–72 hours was chosen because the postoperative right-to-left shunt has nearly normalized after this time period. En bloc esophagectomy and reconstruction with delayed urgency can be performed without disadvantages compared to a 1-stage procedure. It can especially be recommended for operations in which esophagectomy and mediastinal lymphadenectomy are difficult and wearisome.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02414431
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    40. Der Endobrachyoesophagus als Präcancerose (1986)
    Springer
    Langenbeck's archives of surgery 369 (1986), S. 217-223 
    Details
    ISSN: 1435-2451
    Keywords: Barrett's esophagus ; Precancerous stage ; Risk factors ; Indication ; Endobrachyoesophagus ; Precanceroue ; Risikofaktoren ; Indikation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Der Endobrachyoesophagus ist eine Präcancerose, da in etwa 15 der Fälle eine maligne Entartung auftritt. Nach prospektiven Studien liegt das Risiko einer Carcinomentwicklung 30- bis 42mal höher als bei der Normalbevölkerung. Risikofaktoren für die maligne Degeneration sind Alkohol- und Nicotinabusus, chronischer gastro-oesophagealer Reflux, Zugehörigkeit zur weißen Rasse und zum männlichen Geschlecht. Eine Indikation zur Antirefluxchirurgie besteht nur beim Endobrachyoesophagus mit florider Reflux-oesophagitis. Der blande Endobrachyoesophagus bedarf einer endoskopischen Kontrolle. Das Adenocarcinom des Endobrachyoesophagus ist als Speiseröhrencarcinom anzusehen und kann wegen der vorwiegend aboralen Metastasierung durch transmediastinale Oesophagektomie behandelt werden.
    Notes: Summary Barrett's esophagus is a precancerous stage as a malign degeneration occurs in about 15 %. According to prospective studies the risk of development of cancer is 30 to 42 times higher than in the normal population. Risk factors for malign degeneration, which mostly concerns white males, are abuse of alcohol or nicotine and chronic gastroesophageal reflux. Antireflux surgery is only indicated in Barrett's esophagus in combination with active reflux esophagitis. The uncomplicated Barrett's esophagus should be controlled by endoscopy. The adenocarcinoma in Barrett's esophagus has to be considered as an esophageal carcinoma. Due to its metastatic spread in mostly aboräl direction it can be treated by blunt dissection of the esophagus.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01274357
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    191. Das Frühcarcinom des Oesophagus (1987)
    Springer
    Langenbeck's archives of surgery 372 (1987), S. 843-844 
    Details
    ISSN: 1435-2451
    Keywords: Esophagus ; Early carcinoma ; Transthoracic esophagectomy ; Oesophagus ; Frühcarcinom ; Transthorakale Oesophagektomie
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Während die Häufigkeit des Oesophaguscarcinoms in China mit 16% und in Japan mit 7,6% angegeben wird, liegt sie im Patientengut der Chirurgischen Klinik bei 5,4% (n = 15). Das Frühcarcinom der UICC-Klassifikation entpricht den Stadien pT 1 a und 1 b der Japanischen Klassifikation. 60% waren Plattenepithelcarcinome, 40% Adenocarcinome im Endobrachyoesophagus. Zu 60% hatten auch die Plattenepithelcarcinome Frühsymptome im Sinne der Dysphagie (Adenocarcinome 100% dysphagische Beschwerden). Während beim Adenocarcinom die transmediastinale Oesophagektomie ausreichend erscheint, ist beim Plattenepithelcarcinom wegen der Lymphknotenmetastasierung im Stadium pT 1 die transthorakale Enbloc-Oesophagomediastinektomie mit Magenhochzug anzustreben.
    Notes: Summary In China 16% and in Japan 7.6% of the esophageal cancers observed are early carcinomas. In our institution we observed early carcinomas of the esophagus in 5.4% (n = 15) of the cases. Early carcinomas using the UICC classification are comparable to stage pT 1 a and I b with the Japanese classification. Sixty percent are squamous cell carcinomas; 40% adenocarcinomas of the endobrachyesophagus. Sixty percent of the squamous cell carcinomas showed early symptoms like dysphagia (adenocarcinomas, 100% dysphagia). In adenocarcinomas of the esophagus; transmediastinal esophagectomy seems to be an adequate therapy, whereas in squamous cell carcinomas the early lymph-node metastases observed in pT 1 tumors should be treated by thoracic enbloc esophagectomy and mediastinectomy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01297975
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    Paper (German National Licenses)
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  • 4
    Electronic Resource
    Electronic Resource
    281. Sind die Ergebnisse nach Refundoplicatio schlechter als nach primärer Fundoplicatio? (1987)
    Springer
    Langenbeck's archives of surgery 372 (1987), S. 900-900 
    Details
    ISSN: 1435-2451
    Keywords: Fundoplication ; Refundoplication ; Functional results ; Fundoplicatio ; Refundoplicatio ; Funktionelle Ergebnisse
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Von 7/82 bis 12/86 wurden 45 Fundoplikationen und 35 Refundoplikationen durchgeführt. Nach Refundoplicatio waren intra- und postoperative Komplikationen wesentlich häufiger; die Letalität betrug 0% für die Fundoplicatio und 3% für die Refundoplicatio. Bei der Nachuntersuchung nach im Mittel 30 Monaten unterschieden sich die funktionellen Ergebnisse nicht: Der Ruhedruck des unteren Oesophagussphincters lag im Normbereich (15 bzw. 12 mm Hg); pH-metrisch konnte in beiden Gruppen kein gastrooesophagealer Reflux mehr nachgewiesen werden. Trotz des höheren Operationsrisikos und höherer Morbidität im Vergleich zur Erstoperation ist die erneute Fundoplicatio aufgrund gleich guter funktioneller Ergebnisse auch für den Zweiteingriff gerechtfertigt.
    Notes: Summary From July 1982 to December 1986, 45 fundoplications and 34 refundoplications were performed. After refundoplication, the postoperative complications were more frequent. There was no postoperative deaths after fundoplication, but lethality was 3% after refundoplication. The mean follow-up time was 30 months; functional results were comparable in both groups: lower esophagus sphincter pressure was normal in both groups (15 and 12 mm Hg); no gastroesophageal reflux could be detected either. Despite a higher operative risk and higher morbidity, a fundoplication is justified if the primary procedure fails, since equally good results can be obtained.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01298065
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    Paper (German National Licenses)
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