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  • 1985-1989  (3)
  • Transthoracic esophagectomy  (2)
  • En-bloc esophagectomy  (1)
  • Diverticulectomy
  • 1
    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
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Langenbeck's archives of surgery 372 (1987), S. 843-844 
    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
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Langenbeck's archives of surgery 372 (1987), S. 924-924 
    ISSN: 1435-2451
    Keywords: Esophageal carcinoma ; En-bloc esophagectomy ; Mediastinal lymphadenectomy ; Esophagogastrostomy ; Oesophaguscarcinom ; En-bloc-Oesophagektomie ; Mediastinale Lymphadenektomie ; Oesophago-Gastrostomie
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Der Film zeigt die Technik der en-bloc-Oesophagektomie beim Oesophaguscarcinom. Bei dieser Operationstechnik werden der Oesophagus nebst angrenzendem mediastinalem Lymph- und Fettgewebe inclusive der V. azygos und des Ductus thoracicus entfernt. Diese Ausräumung des Mediastinums führt zu einer mediastinalen Lymphadenektomie. Zusätzlich werden Ausmass und Technik der abdominellen Lymphadenektomie gezeigt. Die Rekonstruktion der Speisepassage erfolgt durch Mageninterposition mit cervicaler Oesophago-Gastrostomie.
    Notes: Summary The film shows the technique of en-bloc esophagectomy in esophageal carcinoma. With this surgical technique it is possible to resect the esophagus with the surrounding lymphatic and fatty tissue, including the azygos vein and the thoracic duct. This mediastinectomy leads to a regional lymphadenectomy. In addition, the extent and technique of abdominal lymphadenectomy are also shown. Reconstruction of the food passageway is done by gastric interposition with cervical esophagogastrostomy.
    Type of Medium: Electronic Resource
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