RESUMEN
Twenty patients with carcinoma of the oesophagus treated by a modification of the Ivor Lewis oesophagectomy using two surgeons working synchronously were reviewed. All the patients had carcinomas of the middle or lower thirds of the oesophagus. The median age was 68 years. There were 17 males and 3 females. Average total operating time was 3 h 40 min. There was one peri-operative death. The median length of stay was 15 days. The synchronous combined approach to oesophagectomy has advantages, which are discussed, similar to synchronous combined abdomino-perineal resection of the rectum.
Asunto(s)
Adenocarcinoma/cirugía , Neoplasias Esofágicas/cirugía , Esofagectomía/métodos , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de TiempoRESUMEN
Following an oral hypertonic glucose challenge, gastric emptying and changes in plasma volume were measured in 15 subjects before and in 36 subjects after a truncal or selective vagotomy with a drainage procedure. The symptoms experienced during the test were noted, and the postoperative patients divided into two groups, (a) 20 patients who experienced dumping symptoms during the test and (b) 16 patients who did not. Gastric emptying was significantly faster and the fall in plasma volume significantly greater in those patients who experienced symptoms after the ingestion of hypertonic glucose than in those who did not, clearly demonstrating that the dumping syndrome is associated with an increased rate of gastric emptying. In addition, there was a significant positive correlation between the rate of gastric emptying and the fall in plasma volume.