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1.
Am Surg ; 86(6): 621-627, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32683957

RESUMO

BACKGROUND: To identify the association between the width of the gastric conduit and the benign anastomotic stricture (BAS) after esophagectomy with end-to-side cervical anastomosis for esophageal cancer. METHODS: Patients with esophageal cancer who underwent esophagectomy between July 2013 and July 2014 were included in this study. The gastric conduit was used for reconstruction in all patients and end-to-side cervical anastomosis were performed using a circular stapler. The patients were divided into a narrow group (3-5 cm) and a wide group (>5 cm) based on the gastric conduit width. Univariate and multivariate logistic regressions were used to analyze the possible factors (patients' age, gender, preoperative comorbidities, neoadjuvant chemotherapy, gastric conduit width, anastomotic leakage) that could affect the incidence of BAS. RESULTS: Two-hundred and one patients were included in this study. The median follow-up period was 29 months (17-58 months). Seven cases (3.5%) showed anastomotic leakage in the postoperative period and 38 patients (18.9%) developed BAS; all within the first year of follow-up. In univariate analysis, the width of the gastric conduit was the only risk factor for the development of BAS (odds ratio [OR] = 3.36, P = .005). In multivariate logistic regression analysis, the wide group was an independent significant risk factor for the development of BAS developing compared with the narrow group (OR = 2.84, P = .02). CONCLUSIONS: A wide gastric conduit width (>5 cm) is an independent risk factor for the development of BAS after esophagectomy and stapled cervical end-to-side anastomosis for esophageal cancer.


Assuntos
Anastomose Cirúrgica/efeitos adversos , Constrição Patológica/etiologia , Neoplasias Esofágicas/cirurgia , Esofagectomia/efeitos adversos , Complicações Pós-Operatórias/etiologia , Adulto , Idoso , Anastomose Cirúrgica/métodos , Esofagectomia/métodos , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Estômago/cirurgia
3.
Nihon Shokakibyo Gakkai Zasshi ; 117(7): 619-625, 2020.
Artigo em Japonês | MEDLINE | ID: mdl-32655121

RESUMO

A case of ulcerative colitis (UC) with an internal fistula was reported;the patient, a 42-year-old male, was admitted to the hospital with a diagnosis of refractory UC. The preoperative examination revealed an internal fistula between the transverse colon and the stomach. UC was diagnosed preoperatively with an internal fistula, but the possibility of Crohn's disease could not be ruled out at that time. The patient underwent subtotal colectomy with end ileostomy, sigmoid colon mucous fistula, and partial gastrectomy. UC was diagnosed histopathologically, and an ileal pouch-anal anastomosis was performed. An internal fistula can complicate UC;a split surgery is recommended with the possibility of Crohn's disease in the patient.


Assuntos
Colite Ulcerativa , Fístula , Proctocolectomia Restauradora , Adulto , Colo Transverso , Humanos , Masculino , Estômago , Resultado do Tratamento
5.
Cell Host Microbe ; 28(1): 124-133.e4, 2020 07 08.
Artigo em Inglês | MEDLINE | ID: mdl-32485164

RESUMO

Since December 2019, a novel coronavirus SARS-CoV-2 has emerged and rapidly spread throughout the world, resulting in a global public health emergency. The lack of vaccine and antivirals has brought an urgent need for an animal model. Human angiotensin-converting enzyme II (ACE2) has been identified as a functional receptor for SARS-CoV-2. In this study, we generated a mouse model expressing human ACE2 (hACE2) by using CRISPR/Cas9 knockin technology. In comparison with wild-type C57BL/6 mice, both young and aged hACE2 mice sustained high viral loads in lung, trachea, and brain upon intranasal infection. Although fatalities were not observed, interstitial pneumonia and elevated cytokines were seen in SARS-CoV-2 infected-aged hACE2 mice. Interestingly, intragastric inoculation of SARS-CoV-2 was seen to cause productive infection and lead to pulmonary pathological changes in hACE2 mice. Overall, this animal model described here provides a useful tool for studying SARS-CoV-2 transmission and pathogenesis and evaluating COVID-19 vaccines and therapeutics.


Assuntos
Betacoronavirus/fisiologia , Infecções por Coronavirus , Modelos Animais de Doenças , Camundongos Endogâmicos C57BL , Pandemias , Pneumonia Viral , Envelhecimento , Animais , Encéfalo/virologia , Sistemas CRISPR-Cas , Infecções por Coronavirus/patologia , Infecções por Coronavirus/virologia , Citocinas/sangue , Técnicas de Introdução de Genes , Pulmão/patologia , Pulmão/virologia , Doenças Pulmonares Intersticiais/patologia , Nariz/virologia , Peptidil Dipeptidase A/genética , Peptidil Dipeptidase A/metabolismo , Pneumonia Viral/patologia , Pneumonia Viral/virologia , RNA Viral/análise , Estômago/virologia , Traqueia/virologia , Carga Viral , Replicação Viral
6.
Zhonghua Zhong Liu Za Zhi ; 42(6): 445-448, 2020 Jun 23.
Artigo em Chinês | MEDLINE | ID: mdl-32575938

RESUMO

Objective: To explore the clinical value of totally laparoscopic stomach-partitioning gastrojejunostomy (TLSPGJ) for malignant gastric outlet obstruction. Methods: The clinical data of 9 gastric cancer patients who underwent TLSPGJ in Department of Pancreatic and Gastric Surgery, Cancer Hospital between September 2018 and September 2019 were retrospectively analyzed. Results: The mean operative blood loss of 9 cases were (13.3±5.0) ml, and the average operative time was (103.3±10.6) min. All patients received clear flow food on the first day after surgery. Postoperative first exhaust time was (3.1±0.8) days and the average postoperative hospital stay was (5.4±1.1) days. All of the 9 patients could tolerate semi-liquid food at discharge, and no postoperative complications such as bleeding or delayed gastric emptying occurred. Conclusion: TLSPGJ is an effective treatment for gastric output tract obstruction caused by malignant tumor.


Assuntos
Gastrectomia/métodos , Derivação Gástrica/métodos , Obstrução da Saída Gástrica/patologia , Obstrução da Saída Gástrica/cirurgia , Jejuno/cirurgia , Laparoscopia/métodos , Neoplasias Gástricas/cirurgia , Estômago/cirurgia , Obstrução da Saída Gástrica/etiologia , Humanos , Duração da Cirurgia , Cuidados Paliativos , Estudos Retrospectivos , Neoplasias Gástricas/patologia , Resultado do Tratamento
8.
Zhonghua Yi Xue Za Zhi ; 100(20): 1562-1566, 2020 May 26.
Artigo em Chinês | MEDLINE | ID: mdl-32450645

RESUMO

Objective: To clarify the endoscopic changes prior to corticosteroid therapy in Cronkhite-Canada syndrome (CCS) patients and to explore the correlation between endoscopic features and clinical characteristics. Methods: A total of 24 CCS patients who were hospitalized in Peking Union Medical College Hospital from January 1999 to June 2019 and underwent gastroscopy and colonoscopy before corticosteroid therapy were retrospectively enrolled. The endoscopic images were re-interpreted. The demographic characteristics, clinical manifestations, laboratory tests and histopathological data were collected and analyzed. Results: Of all 24 patients, 15 (62.5%) were male and 9(37.5%) were female, with an average age of (59±10) years and disease course of 6 (1~36) months. Based on the endoscopic findings, the percentages of stomach, colon, duodenum, rectum and terminal ileum involvement were 100%, 100%, 95.7%, 66.7% and 50.0% respectively. Gastric involvement was more severe in the lower part of the body and the antrum of the stomach, while the cardia and the fundus were spared in 5 (20.8%) cases. Colonic involvement was more severe in the right colon. No patient showed remarkable esophageal involvement. The typical appearance under endoscopy were diffuse mucosal hyperemia and edema with polyps or nodular changes. The lesions may have mulberry-like or imbricate changes in severe cases. Lymphatic dilation in the duodenum was found in 47.8% patients. Most of the polyps were pedunculated or sub-pedunculated, with occasionally seen sessile polyps in the colon. The pit patterns of the 12 resected colon polyps in 11 patients could be classified as Kudo type Ⅲ(S), Ⅲ(L), Ⅳ and Ⅴ(I), among which 2 tubular adenomas had the Kudo type Ⅲ(L). Other resected polyps were hyperplastic polyps or CCS polyps. The disease duration prior to diagnosis was positively correlated with the maximum diameter of colon polyps (r=0.625, P=0.006). Serum albumin levels in patients with whole stomach involvement were significantly lower than those in patients with cardia spared [(29±8) g/L vs (37±5) g/L, P=0.034]. Conclusions: The typical initial endoscopic finding of CCS is multiple polyps or nodular changes on the background of diffuse hyperemia and edema lining the gastric, duodenal and colonic mucosa. Lymphatic dilatation in the duodenum could also be found. Some endoscopic features are correlated to clinical characteristics.


Assuntos
Polipose Intestinal , Idoso , Colonoscopia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Estômago
9.
Ecotoxicol Environ Saf ; 200: 110745, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32460051

RESUMO

Chronic dietary bioaccumulation tests with rodents are required for new substances, including engineered nanomaterials (ENMs), in order to provide information on the potential hazards to human health. However, screening tools are needed to manage the diversity of ENMs and alternative methods are desirable with respect to animal welfare. Here, an ex vivo gut sac method was used to estimate the dietary bioaccumulation potential of silver nanomaterials. The entire gastrointestinal tract (except the caecum) was removed and filled with a gut saline containing 1 mg L-1 of Ag as either AgNO3, silver nanoparticles (Ag NPs) or silver sulphide nanoparticles (Ag2S NPs), and compared to controls with no added Ag. The gut sacs were incubated for 4 h, rinsed to remove excess media, and the total Ag determined in the mucosa and muscularis. There was no detected Ag in the control treatments. Within the Ag treatments, 1.4-22% of the exposure dose was associated with the tissues and serosal saline. Within the mucosa of the AgNO3 treatment, the highest Ag concentration was associated with the intestinal regions (3639-7087 ng g-1) compared to the stomach (639 ± 128 ng g-1). This pattern was also observed in the Ag NP and Ag2S NP treatments, but there was no significant differences between any Ag treatments for the mucosa. However, differences between treatments were observed in the muscularis concentration. For example, both the Ag NP (907 ± 284 ng g -1) and Ag2S NP (1482 ± 668 ng g-1) treatments were significantly lower compared to the AgNO3 treatment (2514 ± 267 ng g-1). The duodenum demonstrated serosal accumulation in both the AgNO3 (~10 ng mL-1) and Ag NP (~3 ng mL-1) treatments. The duodenum showed some of the highest Ag accumulation with 41, 61 and 57% of the total Ag in the mucosa compared to the muscularis for the AgNO3, Ag NP and Ag2S NP treatments, respectively. In conclusion, the ex vivo gut sac method demonstrates the uptake of Ag in all Ag treatments, with the duodenum the site of highest accumulation. Based on the serosal saline accumulation, the ranked order of accumulation is AgNO3 > Ag NPs > Ag2S NPs.


Assuntos
Trato Gastrointestinal/metabolismo , Nanopartículas Metálicas , Compostos de Prata/metabolismo , Nitrato de Prata/metabolismo , Prata/metabolismo , Animais , Bioacumulação , Dieta , Intestinos , Membrana Mucosa/metabolismo , Ratos Wistar , Estômago
10.
Ann R Coll Surg Engl ; 102(6): 437-441, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32374217

RESUMO

INTRODUCTION: In the UK, general surgeons must demonstrate competency in emergency general surgery before obtaining a certificate of completion of training. Subsequently, many consultants develop focused elective specialist interests which may not mirror the breadth of procedures encountered during emergency practice. Recent National Emergency Laparotomy Audit analysis found that declared surgeon special interest impacted emergency laparotomy outcomes, which has implications for emergency general surgery service configuration. We sought to establish whether local declared surgeon special interest impacts emergency laparotomy outcomes. METHODS: Adult patients having emergency laparotomy were identified from our prospective National Emergency Laparotomy Audit database from May 2016 to May 2019 and categorised as colorectal or oesophagogastric according to operative procedure. Outcomes included 30-day mortality, return to theatre and length of stay. Binomial logistic regression was used to identify any association between declared consultant specialist interest and outcomes. RESULTS: Of 600 laparotomies, 358 (58.6%) were classifiable as specialist procedures: 287 (80%) colorectal and 71 (20%) oesophagogastric. Discordance between declared specialty and operation undertaken occurred in 25% of procedures. For colorectal emergency laparotomy, there was an increased risk of 30-day mortality when performed by a non-colorectal consultant (unadjusted odds ratio 2.34; 95% confidence interval 1.10-5.00; p = 0.003); however, when adjusted for confounders within multivariate analysis declared surgeon specialty had no impact on mortality, return to theatre or length of stay. CONCLUSION: Surgeon-declared specialty does not impact emergency laparotomy outcomes in this cohort of undifferentiated emergency laparotomies. This may reflect the on-call structure at Birmingham Heartlands Hospital, where a colorectal and oesophagogastric consultant are paired on call and provide cross-cover when needed.


Assuntos
Competência Clínica/normas , Tratamento de Emergência/estatística & dados numéricos , Gastroenteropatias/cirurgia , Laparotomia/estatística & dados numéricos , Cirurgiões/estatística & dados numéricos , Idoso , Certificação/normas , Competência Clínica/estatística & dados numéricos , Colo/cirurgia , Consultores/estatística & dados numéricos , Estado Terminal/mortalidade , Estado Terminal/terapia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Tratamento de Emergência/efeitos adversos , Esôfago/cirurgia , Feminino , Gastroenteropatias/mortalidade , Cirurgia Geral/organização & administração , Cirurgia Geral/normas , Mortalidade Hospitalar , Humanos , Laparotomia/efeitos adversos , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Readmissão do Paciente/estatística & dados numéricos , Estudos Prospectivos , Reto/cirurgia , Reoperação/estatística & dados numéricos , Estômago/cirurgia , Cirurgiões/organização & administração , Cirurgiões/normas , Resultado do Tratamento
11.
PLoS One ; 15(5): e0232240, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32379763

RESUMO

AIM: That clinical trial (RAINBOW) showed that a 7.4 months overall survival benefit with the combination therapy with ramucirumab (RAM) and paclitaxel (PAC) as second-line therapy for patients with recurrent or metastatic gastric or gastro-oesophageal junction adenocarcinoma, compared with placebo (PLA) plus paclitaxel. We performed an analysis to assess the cost-effectiveness of RAM from a Chinese perspective and recognized the range of drug costs. METHODS: By building a Markov model to estimate quality-adjusted life-years (QALYs), life-years (LYs) and lifetime costs. Transition probabilities, costs and utilities were estimated for the published literature, Chinese health care system and local price setting. We performed threshold analyses and probabilistic sensitivity analyses to evaluate the uncertainty of the model. RESULTS: Compared with PLA strategy, RAM strategy provided an incremental survival benefit of 1.22 LYs and 0.64 QALYs. The probabilistic sensitivity analysis showed that when RAM costs less than $151 or $753 per 4 weeks, the incremental cost-effectiveness ratio (ICER) approximated the willingness-to-pay threshold (WTP), suggesting that there was 50% likelihood that the ICER for RAM + PAC would be less than $44528.4 per QALY or $48121 per QALY, respectively. CONCLUSIONS: For patients with advanced gastric or gastro-oesophageal junction adenocarcinoma who fail first-line chemotherapy, our results are conducive to the multilateral drug price guidance negotiations of RAM in China.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/economia , Neoplasias Esofágicas/tratamento farmacológico , Neoplasias Gástricas/tratamento farmacológico , Adenocarcinoma/tratamento farmacológico , Adulto , Anticorpos Monoclonais Humanizados/economia , Anticorpos Monoclonais Humanizados/uso terapêutico , Grupo com Ancestrais do Continente Asiático , China , Análise Custo-Benefício , Neoplasias Esofágicas/economia , Feminino , Humanos , Masculino , Cadeias de Markov , Pessoa de Meia-Idade , Modelos Econômicos , Paclitaxel/economia , Paclitaxel/uso terapêutico , Intervalo Livre de Progressão , Qualidade de Vida , Anos de Vida Ajustados por Qualidade de Vida , Estômago/patologia , Neoplasias Gástricas/economia
13.
Chirurgia (Bucur) ; 115(2): 161-168, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32369720

RESUMO

The objective of this work was to review the entire literature on gastric and bariatric surgery in order to best define the surgical indications and the specifics of their management. A literature review from 1995 to August 2015 was conducted in Pubmed and Google Scholar, using French and English as publication languages. 21 studies were included (level 3 and 4) over 128 identified. In total, if the cirrhotic patients, candidates for gastric surgery, are appropriately selected, long-term survival seems relatively good. No risk factors for long-term survival have been reported. The literature data are insufficient to be able to make recommendations concerning bariatric surgery in the cirrhotic patient.


Assuntos
Cirurgia Bariátrica , Cirrose Hepática/complicações , Obesidade/cirurgia , Estômago/cirurgia , Humanos , Obesidade/complicações
14.
Gan To Kagaku Ryoho ; 47(2): 334-336, 2020 Feb.
Artigo em Japonês | MEDLINE | ID: mdl-32381980

RESUMO

The standard treatment for unresectable or recurrent gastrointestinal stromal tumor(GIST)is tyrosine kinase inhibitor(TKI). It is reported that resection of metastatic lesions after TKI administration prolongs progression free survival, but its influence on overall survival is not clarified. We experienced a case of GIST with peritoneal dissemination for which TKI administration and 2 local resections were effective. The patient was a man in his 70's. We started chemotherapy with imatinib for GIST with peritoneal dissemination. However, it was discontinued due to the occurrence of interstitial pneumonia. Dissemination was evaluated as radically resectable on the images. After the interstitial pneumonia was alleviated, surgery was performed. Although sunitinib was introduced at 2 months postoperatively, recurrent peritoneal dissemination was detected at 32 months postoperatively, and treatment was then changed to regorafenib. Regorafenib treatment reduced the tumor size; however, Grade 3 albuminuria was detected 16 months after treatment initiation and, thus, this treatment was discontinued. Subsequently, the tumor enlarged again. Because there was only 1 recurrent lesion, we performed radical resection. Postoperatively, a reduced dose of regorafenib was re-administered. At present, 9 months after the re-surgery, the patient is alive without recurrence.


Assuntos
Neoplasias Gastrointestinais , Tumores do Estroma Gastrointestinal , Idoso , Neoplasias Gastrointestinais/terapia , Tumores do Estroma Gastrointestinal/terapia , Humanos , Mesilato de Imatinib , Masculino , Recidiva Local de Neoplasia , Estômago
17.
Life Sci ; 254: 117774, 2020 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-32407843

RESUMO

AIMS: Gastric cancer (GC) remains one of the deadliest malignancies worldwide due to its poor prognosis. DNA methylation changes, as an early event during tumor progression, constitute attractive markers for cancer diagnostics. In the current study, CD40 DNA methylation was investigated in GC as a novel epigenetic biomarker. MAIN METHODS: We first analyzed DNA methylation microarrays from the Gene Expression Omnibus database on GC samples to evaluate the potential diagnostic value of CD40 methylation. Moreover, using q-MSP, in a set of internal samples including GC primary tumors and adjacent normal specimens, CD40 DNA methylation levels were determined. The Cancer Genome Atlas (TCGA) data on GC was also analyzed for further validation. KEY FINDINGS: Our results illustrated significant CD40 hypermethylation in GC samples compared to normal specimens which was significantly correlated with the clinical stage of malignancy. Besides, the high accuracy of CD40 methylation as a diagnostic biomarker in GC was confirmed using the ROC curve analysis with an AUC value of 0.9089. Also, gene set enrichment analysis showed that CD40 is mainly involved in biological processes regulating immune response activation in GC. Further analysis of other prevalent cancer entities in TCGA showed that CD40 hypermethylation is a common event during tumor progression and could be considered as a potential biomarker for the detection of breast, colorectal, and prostate cancers as well. SIGNIFICANCE: The finding of this study suggests that CD40 methylation as a potential pan biomarker could be a valuable target for liquid biopsy application of human cancers.


Assuntos
Antígenos CD40/genética , Metilação de DNA , Neoplasias Gástricas/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/genética , Biomarcadores Tumorais/metabolismo , Antígenos CD40/metabolismo , DNA/metabolismo , Bases de Dados Genéticas , Epigênese Genética , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Regiões Promotoras Genéticas , Curva ROC , Estômago/patologia , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/metabolismo , Neoplasias Gástricas/patologia
18.
Khirurgiia (Mosk) ; (4): 70-73, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32352672

RESUMO

Gastric diverticulum is a rather rare disease. This lesion is diagnosed in about 0.01% of cases during contrast-enhanced X-ray examination and in 0.04-0.11% of patients undergoing endoscopic examination. Symptomatic diverticulum is complicated by diverticulitis, bleeding, perforation and malignant transformation. Therefore, surgical resection is indicated. We report surgical treatment of a patient with diverticulum of the cardiac part of the stomach. Endoscopic and X-ray examination was valuable to establish the correct diagnosis. Laparoscopic approach minimized surgical trauma and reduced surgery time.


Assuntos
Divertículo Gástrico/diagnóstico , Divertículo Gástrico/cirurgia , Estômago/cirurgia , Divertículo Gástrico/complicações , Humanos , Laparoscopia
19.
Z Gastroenterol ; 58(5): 456-460, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32392607

RESUMO

Clostridium (C.) ventriculi (known as Sarcina ventriculi) is a ubiquitous gram-positive, anaerobic, acidophilic coccus found in patients with gastric motility disorders. The microorganisms can be identified histologically by their characteristic presentation in tetrads or packets of 8 in hematoxylin and eosin stains. Severe cases of emphysematous gastritis or gastric perforation have been described. Nevertheless, the significance of C. ventriculi in an upper gastrointestinal tract and its pathogenic character remain unclear. We present a 67-year-old woman who underwent hiatoplasty with gastropexy. After 3 months, she underwent a gastroscopy showing gastroesophageal reflux. Biopsies showed ulcerative reflux esophagitis with presence of C.ventriculi, subsequently confirmed by 16S ribosomal RNA gene amplicon sequencing. The barium swallow study revealed an atonic stomach with delayed gastric emptying. The patient was treated with PPI and domperidone. On follow up, 15 months post-operatively, a control gastroscopy showed a stomach with food residues and reflux-associated small erosions. The Clostridium organisms were detected only in oxyntic mucosa biopsies without erosions or ulcerations. We speculate that the recognition of the organisms in the biopsy material is important and suggests dysmotility disorder. However, in our opinion, the presence of C. ventriculi, even in combination with mucosal damage, does not necessarily prompt antibiotic treatment since no complications occurred and inflammation as well as gastric function improved under PPI and prokinetic therapy in our patient. Larger study groups with long-term follow-up are needed to understand whether these organisms could behave as pathogens or are only bystanders in the setting of delayed gastric emptying.


Assuntos
Clostridium/isolamento & purificação , Domperidona/uso terapêutico , Esofagite Péptica/tratamento farmacológico , Esofagite Péptica/microbiologia , Refluxo Gastroesofágico/complicações , Complicações Pós-Operatórias/microbiologia , Idoso , Antibacterianos/uso terapêutico , Antieméticos/uso terapêutico , Infecções por Clostridium/diagnóstico , Infecções por Clostridium/tratamento farmacológico , Infecções por Clostridium/microbiologia , Esofagite Péptica/diagnóstico , Feminino , Refluxo Gastroesofágico/diagnóstico por imagem , Gastropexia , Gastroscopia , Humanos , Inibidores da Bomba de Prótons/uso terapêutico , Estômago/cirurgia
20.
Khirurgiia (Mosk) ; (4): 18-23, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32352663

RESUMO

OBJECTIVE: To study the long-term results of reconstructive procedures for esophageal strictures and evaluate quality life after each type of esophageal repair using own criteria. MATERIAL AND METHODS: The study was conducted among patients who underwent esophageal repair with gastric transplant (172), colonic transplant (25), intestinal transplant (14) and repair of short cervical strictures (7). The age of patients ranged from 5 to 60 years. All patients underwent X-ray and endoscopic examination. Survey also included external respiration function and cardiac function, digestive function, measurement of height and weight, analysis of social aspects (work, study), female genital function. Five-score scale for quality of life assessment was developed. RESULTS: Long-term results were studied in 218 patients for the period from 3 months to 31 years (2002-2017). Excellent and good results were obtained in 180 patients. The best results were obtained after repair of short cervical strictures (4.42 scores), good results - after esophageal repair with gastric (4.14 scores) and intestinal (4.07 scores) transplants. Colonic repair was followed by satisfactory outcome (3.16 scores). CONCLUSION: Gastric and small bowel grafts are preferred for total esophageal repair due to better quality of life in long-term postoperative period.


Assuntos
Colo/transplante , Estenose Esofágica/cirurgia , Esofagoplastia/métodos , Intestino Delgado/transplante , Qualidade de Vida , Estômago/transplante , Adolescente , Adulto , Criança , Pré-Escolar , Humanos , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Reconstrutivos , Resultado do Tratamento , Adulto Jovem
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