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3.
J Vet Intern Med ; 36(1): 196-203, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34786762

RESUMO

BACKGROUND: Esophagostomy tubes (E-tubes) are widely utilized for extended nutritional support in dogs and cats. Problems associated with their use include the unwieldy excess (10-20 cm) of external tubing, constant need for neck wraps and necessity for skin sutures, suture tract infection, and tube loss if sutures fail. OBJECTIVES: To evaluate 2 different, low profile (LP) "button" products intended for use in people as enteral (jejunostomy [J] and gastrojejunostomy [G-J]) feeding tubes for suitability as LP E-tubes in dogs and cats. ANIMALS: A young giant breed dog that required extended (>6 months) nutritional and fluid support during recovery from severe neurological illness with protracted adipsia, anorexia, and dysphagia. METHODS: Prospective evaluation of 2 commercially available LP feeding devices after placement of a standard E-tube. An LP J-tube and an LP G-J tube were assessed in consecutive 4-week trials, for tube retention, patient comfort, stoma health, and functionality. RESULTS: Both products performed extremely and equally well as LP E-tubes in this clinical patient, enhancing patient freedom and comfort by eliminating external tubing, skin sutures, and bandaging. The dual port G-J tube allows medication delivery (eg, sucralfate) to the entire esophagus, but for safety alone (ie, to avoid aspiration), the single port J-tube appears the best device for client-owned patients. CONCLUSIONS AND CLINICAL IMPORTANCE: The LP enteral feeding tubes from the human medical field can be successfully used as LP E-tubes in dogs and cats, offering superior patient comfort, with no obvious detriment to the patient and main drawback of higher cost.


Assuntos
Doenças do Gato , Doenças do Cão , Animais , Doenças do Gato/cirurgia , Gatos , Cães , Nutrição Enteral/veterinária , Esofagostomia/veterinária , Esôfago , Humanos
4.
Ann Thorac Surg ; 113(2): e83-e85, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34058164

RESUMO

A 67-year-old woman underwent esophagogastroduodenectomy, partial jejunectomy, pancreaticojejunostomy, cervical esophagostomy, and feeding jejunostomy at the age of 42 for corrosive necrosis. She underwent esophageal reconstruction using the ileocolon through the substernal route 4 months later. Twenty-five years after esophageal reconstruction, the proximal part of the neoesophagus was obstructed by the innominate artery barrier. She could eat regular diets after revision surgery.


Assuntos
Estenose Esofágica/cirurgia , Esofagectomia/métodos , Esofagoplastia/métodos , Esofagostomia/métodos , Esôfago/cirurgia , Jejunostomia/métodos , Idoso , Feminino , Humanos
5.
BMC Cancer ; 21(1): 1016, 2021 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-34511059

RESUMO

BACKGROUND: This study aimed to evaluate the surgical outcome and quality of life (QoL) of totally laparoscopic total gastrectomy (TLTG) compared with laparoscopy-assisted total gastrectomy (LATG) in patients with clinical stage I gastric cancer. METHODS: From 2012 to 2018, EGC patients who underwent TLTG (n = 223), including the first case with intracorporeal hemi-double stapling, were matched to those who underwent LATG (n = 114) with extracorporeal circular stapling, using 2:1 propensity score matching (PSM). Prospectively collected morbidity was compared between the TLTG and LATG groups in conjunction with the learning curve. The European Organization for Research and Treatment of Cancer (EORTC) QoL questionnaires QLQ-C30, STO22, and OG25 were prospectively surveyed during postoperative 1 year for patient subgroups. RESULTS: After PSM, grade I pulmonary complication rate was lower in the TLTG group (n = 213) than in the LATG group (n = 111) (0.5% vs. 5.4%, P = 0.007). Other complications were not different between the groups. The learning curve of TLTG was overcome at the 26th case in terms of the comprehensive complication index. The TLTG group after learning curve showed lower grade I pulmonary complication rate than the matched LATG group (0.5% vs. 4.7%, P = 0.024). Regarding postoperative QoL, the TLTG group (n = 63) revealed less dysphagia (P = 0.028), pain (P = 0.028), eating restriction (P = 0.006), eating (P = 0.004), odynophagia (P = 0.023) than the LATG group (n = 21). Multivariate analyses for each QoL item demonstrated that TLTG was the only common independent factor for better QoL. CONCLUSIONS: TLTG reduced grade I pulmonary complications and provided better QoL in dysphagia, pain, eating, odynophagia than LATG for patients with clinical stage I gastric cancer.


Assuntos
Gastrectomia/efeitos adversos , Laparoscopia/efeitos adversos , Complicações Pós-Operatórias/epidemiologia , Qualidade de Vida , Neoplasias Gástricas/cirurgia , Transtornos de Deglutição/epidemiologia , Esofagostomia/métodos , Feminino , Gastrectomia/métodos , Humanos , Jejunostomia/métodos , Laparoscopia/métodos , Curva de Aprendizado , Pneumopatias/epidemiologia , Masculino , Ilustração Médica , Pessoa de Meia-Idade , Dor Pós-Operatória/epidemiologia , Complicações Pós-Operatórias/etiologia , Pontuação de Propensão , Neoplasias Gástricas/patologia , Grampeamento Cirúrgico/métodos , Inquéritos e Questionários , Resultado do Tratamento
6.
J Surg Oncol ; 124(8): 1329-1337, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34432310

RESUMO

BACKGROUND: Regarding the overlap anastomosis and recently introduced π-shaped anastomosis, there is no consensus on which intracorporeal esophagojejunostomy (EJS) methods are preferred using linear stapler in totally laparoscopic total gastrectomy (TLTG). This study aims to evaluate the short-term outcomes using two methods. METHODS: Patients with upper gastric cancer underwent TLTG with either π-shaped (n = 48) or the modified overlap method using knotless barbed sutures (MOBS) (n = 37) were included in our study. Intraoperative and perioperative outcomes were compared. RESULTS: All patients achieved R0 resection margin. The overall esophagojejunal (E-J)-related complications rate was 7.06%. There was no significant difference between the two groups in terms of postoperative complications, margin distance, numbers of lymph nodes (LNs), length of stay. In the π-shaped group, anastomosis time (19.61 ± 7.17 min vs. 27.09 ± 3.59 min, p < 0.001) was significantly lower. The consumable costs for surgery were similar (44 507.74¥ [42 933.03-46 937.29] vs. 43 718.36¥ [42 743.25-47 256.06], p = 0.825). The first defection time was significantly longer in π-shaped group (131.00 h [93.75-171.25] vs. 100.00 h [85.00-120.00], p = 0.026), whereas the other postoperative recovery parameters were similar. No mortality was observed. CONCLUSIONS: Both methods showed similar short-term postoperative outcomes. The π-shaped technique was faster than the MOBS method without significantly increasing the supplies costs. Large prospective studies are warranted.


Assuntos
Anastomose Cirúrgica/métodos , Esofagostomia/métodos , Gastrectomia/métodos , Jejunostomia/métodos , Laparoscopia/métodos , Neoplasias Gástricas/cirurgia , Idoso , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Neoplasias Gástricas/patologia , Taxa de Sobrevida
7.
Surg Oncol ; 38: 101580, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33862577

RESUMO

OBJECTIVE: To assess long-term functional and quality of life (QoL) outcomes and their predictive factors in laryngectomized patients after successful voice restoration using tracheoesophageal prostheses (TEP). METHODS: This cross-sectional study was conducted in alive and disease-free patients at least 1 year after total laryngectomy ± partial pharyngectomy. Patients completed the European Organization for Research and Treatment of Cancer (EORTC) Core (QLQ-C30) and Head and Neck Cancer (QLQ-H&N35) QoL questionnaires, the Voice Handicap Index (VHI-10) questionnaire and the Hospital Anxiety and Depression Scale (HADS). The level of dysphagia was evaluated using the Dysphagia Handicap Index (DHI) and the Dysphagia Outcomes and Severity Scale (DOSS). Predictive factors of these clinical outcomes were determined in univariate and multivariate analysis. RESULTS: A total of 48 patients were included in this study. Long-term QoL and functioning scales scores were all superior to 70%. Main persistent symptoms were fatigue, dyspnea, senses, speech and coughing problems. A DOSS score ≥6, indicating normal/subnormal swallowing function, and a VHI-10 score ≤20, representing light to medium voice disorders, were found in at least 75% of patients. An anxiodepressive disorder (HADS global score ≥ 15) was reported by 15 (31%) patients and represented the main predictor of QoL and voice outcomes. A strong correlation was found between VHI-10 and global QoL scores. CONCLUSIONS: After successful voice restoration, laryngectomized patients achieved satisfactory QoL and functional outcomes. Psychological distress was the main determinant of long-term QoL and is therefore of critical importance in the multidisciplinary management of laryngectomized patients.


Assuntos
Transtornos de Deglutição/patologia , Neoplasias Laríngeas/cirurgia , Laringectomia/reabilitação , Complicações Pós-Operatórias/patologia , Implantação de Prótese/efeitos adversos , Qualidade de Vida , Distúrbios da Voz/patologia , Idoso , Estudos Transversais , Transtornos de Deglutição/etiologia , Esofagostomia/efeitos adversos , Feminino , Seguimentos , Humanos , Neoplasias Laríngeas/reabilitação , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Prognóstico , Estresse Psicológico/etiologia , Estresse Psicológico/patologia , Inquéritos e Questionários , Traqueostomia/efeitos adversos , Voz , Distúrbios da Voz/etiologia
9.
Cancer Res Treat ; 53(3): 784-794, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33421979

RESUMO

PURPOSE: The aim of the present study was to compare the difference between double tract reconstruction and esophagogastrostomy. MATERIALS AND METHODS: Patients who underwent radical proximal gastrectomy with esophagogastrostomy or double tract reconstruction were included in this study. RESULTS: Sixty-four patients were included in this study and divided into two groups according to reconstruction method. The two groups were well balanced in perioperative safety and 3-year overall survival (OS). The rates of postoperative reflux esophagitis in the double tract reconstruction group and esophagogastrostomy group were 8.0% and 30.8%, respectively (p=0.032). Patients in the double tract reconstruction group had a better global health status (p < 0.001) and emotional functioning (p < 0.001), and complained less about nausea and vomiting (p < 0.001), pain (p=0.039), insomnia (p=0.003), and appetite loss (p < 0.001) based on the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 questionnaire. Regarding the EORTC QLQ-STO22 questionnaire, patients in the double tract reconstruction group complained less about dysphagia (p=0.030), pain (p=0.008), reflux (p < 0.001), eating (p < 0.001), anxiety (p < 0.001), dry mouth (p=0.007), and taste (p=0.001). The multiple linear regression analysis showed that reconstruction method, postoperative complications, reflux esophagitis, and operation duration had a linear relationship with the global health status score. CONCLUSION: Double tract reconstruction could better prevent reflux esophagitis and improve quality of life without scarifying perioperative safety or 3-year OS.


Assuntos
Adenocarcinoma/cirurgia , Esofagite Péptica/epidemiologia , Gastrectomia/efeitos adversos , Complicações Pós-Operatórias/epidemiologia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Neoplasias Gástricas/cirurgia , Adenocarcinoma/patologia , Idoso , Esofagite Péptica/etiologia , Esofagite Péptica/prevenção & controle , Junção Esofagogástrica/patologia , Junção Esofagogástrica/cirurgia , Esofagostomia/métodos , Esofagostomia/estatística & dados numéricos , Feminino , Gastrostomia/métodos , Gastrostomia/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Estudos Prospectivos , Qualidade de Vida , Procedimentos Cirúrgicos Reconstrutivos/estatística & dados numéricos , Estudos Retrospectivos , Neoplasias Gástricas/patologia , Resultado do Tratamento
10.
J Visc Surg ; 158(5): 425-428, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-33745858

Assuntos
Esofagostomia , Humanos
12.
J Laparoendosc Adv Surg Tech A ; 31(7): 803-807, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33232633

RESUMO

Background: Remnant gastric cancer (RGC) is increasing due to past use of subtotal gastrectomy to treat benign diseases, improvements in the detection of gastric cancer, and increased survival rates after gastrectomy for gastric cancer. Laparoscopic access provides the advantages and benefits of minimally invasive surgery. However, laparoscopic completion total gastrectomy (LCTG) for RGC is technically demanding, even for experienced surgeons. Because of its rarity and heterogeneity, no standard surgical strategy has been established and few surgeons will develop technical expertise to carry out this procedure. Aim: To describe our standard technique, giving surgeons a head start in LCTG and report the early experience with this stepwise approach. Materials and Methods: We detail all the steps involved in the procedure, including trocar placement and surgical description. Results: Between 2009 and 2019, a total of 8 patients with past history of RGC were operated with this technique. All patients had been previously operated by open method, 7 due to peptic ulcer disease and 1 due to gastric cancer. Their mean age at the time of the first surgery was 38.9 years (range 25-56 years) and the mean interval between the first and the second gastrectomy was 32.1 years (range 13.6-49). Billroth II was the previous reconstruction in all cases. A 5-trocar technique was used followed by total gastrectomy with side-to-side stapled intracorporeal esophagojejunostomy anastomosis and Roux-en-Y reconstruction. The mean operation time was 272 minutes (range 180-330) and median blood loss was 247 mL (range 50-500). There was no conversion and no major intraoperative complication. Major postoperative complications occurred in 3 patients. Conclusion: Completion total gastrectomy for RGC is a morbid procedure and laparoscopic access is technically feasible, hopefully carrying the benefits of faster recovery, reduced postoperative pain, and wound complications. By standardizing the approach, the learning curve may be shortened and better results achieved.


Assuntos
Gastrectomia/métodos , Coto Gástrico/cirurgia , Laparoscopia/métodos , Complicações Pós-Operatórias/cirurgia , Reoperação/métodos , Adulto , Idoso , Anastomose Cirúrgica/métodos , Esofagostomia/métodos , Esôfago/cirurgia , Estudos de Viabilidade , Gastroenterostomia/efeitos adversos , Humanos , Jejunostomia/métodos , Jejuno/cirurgia , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Complicações Pós-Operatórias/etiologia , Neoplasias Gástricas/cirurgia , Resultado do Tratamento
13.
Surg Endosc ; 35(3): 1156-1163, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-32144557

RESUMO

BACKGROUND: Laparoscopic distal gastrectomy for early gastric cancer has been widely accepted, but laparoscopic total gastrectomy has still not gained popularity because of technical difficulty and unsolved safety issue. We conducted a single-arm multicenter phase II clinical trial to evaluate the safety and the feasibility of laparoscopic total gastrectomy for clinical stage I proximal gastric cancer in terms of postoperative morbidity and mortality in Korea. The secondary endpoint of this trial was comparison of surgical outcomes among the groups that received different methods of esophagojejunostomy (EJ). METHODS: The 160 patients of the full analysis set group were divided into three groups according to the method of EJ, the extracorporeal circular stapling group (EC; n = 45), the intracorporeal circular stapling group (IC; n = 64), and the intracorporeal linear stapling group (IL; n = 51). The clinicopathologic characteristics and the surgical outcomes were compared among these three groups. RESULTS: There were no significant differences in the early complication rates among the three groups (26.7% vs. 18.8% vs. 17.6%, EC vs. IC vs. IL; p = 0.516). The length of mini-laparotomy incision was significantly longer in the EC group than in the IC or IL group. The anastomosis time was significantly shorter in the EC group than in the IL group. The time to first flatus was significantly shorter in the IL group than in the EC group. The long-term complication rate was not significantly different among the three groups (4.4% vs. 12.7% vs. 7.8%; EC vs. IC vs. IL; p = 0.359), however, the long-term incidence of EJ stenosis in IC group (10.9%) was significantly higher than in EC (0%) and IL (2.0%) groups (p = 0.020). CONCLUSIONS: The extracorporeal circular stapling and the intracorporeal linear stapling were safe and feasible in laparoscopic total gastrectomy, however, intracorporeal circular stapling increased EJ stenosis.


Assuntos
Esofagostomia/métodos , Gastrectomia/métodos , Jejunostomia/métodos , Laparotomia/métodos , Neoplasias Gástricas/cirurgia , Idoso , Anastomose Cirúrgica/métodos , Constrição Patológica/etiologia , Esofagostomia/efeitos adversos , Feminino , Gastrectomia/efeitos adversos , Humanos , Jejunostomia/efeitos adversos , Laparoscopia/métodos , Laparotomia/efeitos adversos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Complicações Pós-Operatórias/etiologia , República da Coreia , Estudos Retrospectivos , Neoplasias Gástricas/patologia , Resultado do Tratamento
14.
J Small Anim Pract ; 62(3): 194-199, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33260259

RESUMO

OBJECTIVES: To retrospectively assess the rate of oesophagostomy tube-related complications in azotaemic dogs, the influence of the oesophagostomy tube (o-tube) duration and the therapeutic approach (medical versus haemodialysis) on the complication rate. MATERIALS AND METHODS: Medical records were retrospectively reviewed in order to identify azotaemic dogswhich underwent o-tube placement. o-Tube duration (short-term versus long-term), time of o-tube change, therapeutic approach (medical versus haemodialysis), prevalence of minor (malposition, suture related, inflammation, muco-purulent discharge, abscess) and major (haemorrhage, malposition, obstruction, dislodgement, vomiting of the tube, food coming from the stoma) o-tube-related complications were extracted. Univariate and multivariate logistic regression analysis were performed to identify the risk factors for o-tube-related complications. RESULTS: Tube-related complications were reported in 74 of 139 dogs (53%). Minor complications were reported in 66 of 74 (89%) and major complications in eight of 74 (11%). In azotaemic dogs, o-tube indwelling time (odds ratio (OR) 1.03; 95% confidence interval (CI) 1.01 to 1.05), and the use of haemodialysis (OR 40.12; 95% CI 9.18 to 175.20) were risk factors for o-tube-related complications. CLINICAL SIGNIFICANCE: The majority of o-tube-related complications were minor, and easily manageable, with no need of hospitalisation, tube-removal or euthanasia. In azotaemic dogs, the use of haemodialysis was strongly associated with a higher risk of o-tube-related complications, possibly as a consequence of the presence of the neck bandage.


Assuntos
Doenças do Cão , Esofagostomia , Animais , Doenças do Cão/cirurgia , Cães , Esofagostomia/veterinária , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/veterinária , Estudos Retrospectivos , Vômito/veterinária
15.
Afr J Paediatr Surg ; 17(3 & 4): 45-48, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33342832

RESUMO

BACKGROUND: Oesophageal colonic interposition in oesophageal atresia (OA) patients is almost exclusively done as a staged operation with an initial oesophagostomy and gastrostomy followed by the definitive surgery months later. This study presents a series of patients in whom a cervical oesophagostomy was not performed before the substitution surgery. PATIENTS AND METHODS: Records of EA patients were evaluated for those who underwent colon interposition without cervical oesophagostomy. RESULTS: There were five patients: three with pure EA and two with proximal tracheo-oesophageal fistula. A delayed primary repair could not be performed because of intra-abdominally located distal pouch. The mean age at the time of definitive operation was 5.54 (±2.7) months and the mean weight was 6.24 (±1.3) kg. A right or a left colonic segment was used for interposition keeping the proximal anastomosis within the thorax. The post-operative results were quite satisfactory within a median follow-up period of 33.2 months. CONCLUSION: Avoiding cervical oesophagostomy and its inherent complications and drawbacks is possible in a subset of patients with long-gap EA who underwent colonic substitution surgery. This approach may be seen as an extension of the consensus that the native oesophagus should be preserved whenever possible, because it uses the native oesophagus in its entirety.


Assuntos
Colo/cirurgia , Atresia Esofágica/cirurgia , Gastrostomia/métodos , Adulto , Anastomose Cirúrgica/métodos , Endoscopia Gastrointestinal , Esofagostomia , Feminino , Humanos , Masculino , Resultado do Tratamento
18.
Langenbecks Arch Surg ; 405(4): 541-549, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32504205

RESUMO

AIMS: No ideal and generally accepted method of reconstruction for laparoscopic proximal gastrectomy (LPG) has been established because of a high incidence of postoperative reflux and anastomotic stenosis. The aim of this study was to evaluate the short-term outcomes of LPG with a non-flap hand-sewn technique as a simple anti-reflux procedure for the upper part of clinical Stage I gastric cancer. METHODS: Between November 2016 and June 2019, 23 consecutive gastric cancer patients, who underwent curative LPG with lymphadenectomy, were enrolled in the study. In this study, we devised a simple hand-sewn technique for esophagogastrostomy, which comprises a 5-cm pseudo-fornix as a fundoplication, the posterior pressure mechanism by the remnant stomach and bilateral crus, and a flat-shaped anastomotic hole as a valvuloplasty. RESULTS: The median operation time and hospital stay was 325 min and 10 days, respectively. There was no patient with anastomotic leakage and delayed gastric empting. No patient had symptoms of gastroesophageal reflux, but two patients (8.6% (2/23): Grade M and Grade A) had endoscopic findings during a follow-up period of more than 6 months. There was no patient with Grade B or more severe reflux esophagitis. One patient (4.3%, 1/23) developed anastomotic stenosis, which was resolved with endoscopic dilatation. The mean body weight loss at 6 months after surgery was 7.5% in comparison with the preoperative body weight. CONCLUSION: Our non-flap hand-sewn technique for esophagogastrostomy had favorable outcomes and might be one of reliable techniques as an anti-reflux procedure in LPG for gastric cancer.


Assuntos
Esofagostomia/métodos , Gastrectomia/efeitos adversos , Refluxo Gastroesofágico/prevenção & controle , Gastrostomia/métodos , Complicações Pós-Operatórias/prevenção & controle , Neoplasias Gástricas/cirurgia , Idoso , Idoso de 80 Anos ou mais , Feminino , Refluxo Gastroesofágico/etiologia , Humanos , Laparoscopia , Excisão de Linfonodo , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia
19.
Langenbecks Arch Surg ; 405(4): 521-532, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32388717

RESUMO

BACKGROUND: This study compared the outcome between patients who had an open and those who had a hybrid esophagectomy for T1 or T3 esophageal adenocarcinoma (eAC). No clear data are available concerning this question based on T-category. METHODS: Two groups of patients with esophagectomy and high intrathoracic esophagogastrostomy for eAC were analyzed: hybrid (laparoscopy + right thoracotomy) (n = 835) and open (laparotomy + right thoracotomy) (n = 188). Outcome criteria were 30- and 90-day mortality, R0-resection rate (R0), number of resected lymph nodes (rLNs), and 5-year survival rate (5y-SR). For each type of surgery, three patient groups were analyzed: pT1-carcinoma (group-1), cT3Nx and neoadjuvant chemoradiation (group-2), and pT3N0-3 without neoadjuvant therapy (group-3). The comparison was based on a propensity score matching in relation of 1:2 for open versus hybrid. RESULTS: In group-1 (38 open vs 76 hybrid) R0-resection (100%), 30-day mortality (0%), 90-day mortality (2.6% vs 0%), and rLNs (median 29.5 vs 28.5) were not significantly different. The pN0-rate was 76% in the open and 92% in the hybrid group (p = 0.036). Accordingly, the 5y-SR was 69% and 87% (p = 0.016), but the prognosis of the subgroups pT1pN0 or pT1pN+ was not significantly different between open or hybrid. In group-2 (68 open vs 135 hybrid) R0-resection (97%), 30-day (0% vs 0.7%) and 90-day (4%) mortality, rLNs (28.5 vs 26), and 5y-SR (36% vs 41%) were not significantly different. In group-3 (37 open vs 75 hybrid) R0, postoperative mortality, rLNs, and 5y-SR were not significantly different. CONCLUSION: In a propensity score-matched comparison of patients with an open or hybrid esophagectomy for esophageal adenocarcinoma the quality of oncologic resection, postoperative mortality and prognosis are not different.


Assuntos
Adenocarcinoma/cirurgia , Neoplasias Esofágicas/cirurgia , Esofagectomia , Adenocarcinoma/mortalidade , Adenocarcinoma/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias Esofágicas/mortalidade , Neoplasias Esofágicas/patologia , Esofagostomia , Feminino , Gastrostomia , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Minimamente Invasivos , Pontuação de Propensão , Estudos Retrospectivos , Taxa de Sobrevida , Adulto Jovem
20.
BMJ Case Rep ; 13(2)2020 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-32086323

RESUMO

The present manuscript reports two extremely rare cases of coexisting emphysematous gastritis with gastric mucormycosis. The cases were managed successfully, considering the high mortality associated with both conditions independently. The aim of the manuscript is to elucidate the importance of prompt diagnosis, early surgical intervention for source control and concomitant application of antifungal therapy for a favourable outcome.


Assuntos
Infecções Bacterianas/complicações , Enfisema/complicações , Gastrite/complicações , Mucormicose/complicações , Estômago/patologia , Idoso , Anastomose em-Y de Roux , Antifúngicos/uso terapêutico , Infecções Bacterianas/terapia , Enfisema/terapia , Esofagostomia , Feminino , Gastrectomia , Gastrite/terapia , Humanos , Jejunostomia , Mucormicose/terapia , Doenças Raras/terapia , Resultado do Tratamento
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