[Use of intraoperative fiber-esophagoscopy in surgical treatment of rare esophageal diseases]. / Zastosowanie sródoperacyjnej fiberoezofagoskopii w chirurgicznym leczeniu rzadko wystepujacych chorób przelyku.

UNLABELLED: The aim of our study is to discuss our observations concerning surgical treatment of rare diseases of the oesophagus. 10 patients were operated on, 6 cases with benign tumours (including leiomyoma, Abrikossoff tumour, polyp of oesophageal mucose), 2 with intramural bronchogenic cysts of the oesophagus, 1 with benign stricture after inflammation and 1 with stricture of oesophagogastric anastomosis after Akiyama operation. In 6 cases tumour was resected without opening of the oesophageal lumen (enucleation), in 4 patients with tumours located on one of the walls, the wedge resection, transversely to the long oesophageal axis was performed. In cases with tumour located in mucose (Abrikossoff tumour, polyp, post-inflammatory scar), intraoperative fiber-esophagoscopy was conducted simultaneously to enable the exact localisation of tumour and evaluation of radical resection. There were no postoperative complications and dysphagia showed regression. The remote results (from 1 year to 6 years) have been found to be satisfactory. CONCLUSIONS: 1. The procedure of choice in the treatment of the intramural cysts and benign tumour of the oesophagus is enucleation and wedge resection with suture in layers in the tumour located in mucose. 2. Intraoperative fiber-esophagoscopy enables the exact lesion localisation and evaluation of radical resection.

[Esophagogastric bypass anastomosis for benign stricture of cardia]. / Zespolenie przelykowo-zoladkowe w nienowotworowych zwezeniach wpustu.

The aim of the study is to discuss our observations concerning oesophagogastric bypass anastomosis in cases with scar stricture of cardia in long-term achalasia (megaoesophagus). The Heller operation is ineffective in such patients and the resection of cardia with oesophagogastric anastomosis is a large and controversial operation. 16 patients were operated (6 of them after ineffective cardiomyotomy). In all cases long-term dysphagia, big loss of weight and large, S-shaped oesophagus lying on the diaphragm were found. The left side thoracotomy was performed and fundus of the stomach was dislocated to the chest through dilatatored oesophageal hiatus and with the oesophagus above the cardia. There were no postoperative complications. However, dysphagia regressed. The remote results (from 1 year to 7 years) in 11 patients were analysed. The general condition was satisfactory. No dysphagia and gastrooesophageal reflux was revealed. Anastomosis was efficient in X-ray examination. Our observations indicate that oesophagogastric anastomosis is a procedure of choice in the treatment of long-term achalasia with stricture of cardia and megaoesophagus.