Patients with esophageal cancer often require esophagectomy with esophagogastrostomy.However,the incidence of complications,such as hemorrhage,during operations for esophageal cancer is high,even with minimally invasi...Patients with esophageal cancer often require esophagectomy with esophagogastrostomy.However,the incidence of complications,such as hemorrhage,during operations for esophageal cancer is high,even with minimally invasive surgery.Without the appropriate interventions,the risk of major intraoperative and postoperative hemorrhage is very high in patients with esophageal cancer and hemophilia.We report the case of a 45-year-old man with esophageal cancer and hemophilia B who underwent a successful hybrid,minimally invasive Ivor-Lewis esophagectomy with appropriate perioperative management.展开更多
Recent studies have suggested the existence of a patient population with esophageal eosinophilia that responds to proton pump inhibitor therapy.These patients are being referred to as having proton pump inhibitor resp...Recent studies have suggested the existence of a patient population with esophageal eosinophilia that responds to proton pump inhibitor therapy.These patients are being referred to as having proton pump inhibitor responsive esophageal eosinophilia(PPI-REE),which is currently classified as a distinct and separate disease entity from both gastroesophageal reflux disease(GERD)and eosinophilic esophagitis(EoE).The therapeutic effect of proton pump inhibitor(PPI)on PPI-REE is thought to act directly at the level of the esophageal mucosa with an anti-inflammatory capacity,and completely independent of gastric acid suppression.The purpose of this manuscript is to review the mechanistic data of the proposed immune modulation/anti-inflammatory role of the PPI at the esophageal mucosa,and the existence of PPI-REE as a distinct disease entity from GERD and EoE.展开更多
AIM: To examine the expression of cyclooxygenase-2 (COX-2) and prostaglandin E2 (PGE2) in rat esophageal lesions induced by reflux of duodenal contents.
High resolution manometry(HRM) is a new technology that made important contributions to the field of gastrointestinal physiology. HRM showed clear advan-tages over conventional manometry and it allowed the creation of...High resolution manometry(HRM) is a new technology that made important contributions to the field of gastrointestinal physiology. HRM showed clear advan-tages over conventional manometry and it allowed the creation of different manometric parameters. On the other side, conventional manometry is still wild available. It must be better studied if the new technology made possible the creation and study of these parameters or if they were always there but the colorful intuitive panoramic view of the peristalsis from the pharynx to the stomach HRM allowed the human eyes to distinguish subtle parameters unknown or uncomprehend so far and if HRM parameters can be reliably obtained by conventional manometry and data from conventional manometry still can be accepted in achalasia studies. Conventional manometry relied solely on the residual pressure to evaluate lower esophageal sphincter(LES) relaxation while HRM can obtain the Integrated Relaxation Pressure. Esophageal body HRM parameters defines achalasia subtypes, the Chicago classification, based on esophageal pressurization after swallows. The characterization of each subtype is very intuitive by HRM but also easy by conventional manometry since only wave amplitudes need to be measured. In conclusion, conventional manometry is still valuable to classify achalasia according to the Chicago classification. HRM permits a better study of the LES.展开更多
目的探讨胸腹腔镜联合微创Ivor-Lewis手术(MIILE)治疗中下段食管癌患者的临床疗效.方法将95例中下段食管癌患者分为行胸腹腔镜+MIILE的MIILE组(43例)和行微创McKeown术(MIME)的MIME组(52例),对比两组围手术期指标、术后并发症、术后疼...目的探讨胸腹腔镜联合微创Ivor-Lewis手术(MIILE)治疗中下段食管癌患者的临床疗效.方法将95例中下段食管癌患者分为行胸腹腔镜+MIILE的MIILE组(43例)和行微创McKeown术(MIME)的MIME组(52例),对比两组围手术期指标、术后并发症、术后疼痛和术后生存率.结果 MIILE组手术时间、术中出血量、术后进食时间、术后住院时间均低于MIME组(P<0.05);两组清扫淋巴结数、淋巴结转移率、R0切除率、术后拔胸管时间比较差异无统计学意义(P>0.05);MIILE组术后并发症总发生率低于MIME组(P<0.05);MIILE组术后1,7d视觉模拟评分法(VAS)均低于MIME组(P<0.05);两组术后14 d VAS评分差异无统计学意义(P>0.05);MIILE组术后1个月生活质量核心量表(QLQ-30)评分高于MIME组(P<0.05),两组复发或转移率、生存率及术后6个月QLQ-30评分差异无统计学意义(P>0.05).结论胸腹腔镜联合MIILE是治疗中下段食管癌安全有效的微创手术,可减少术后并发症,提高患者早期的生活质量.展开更多
文摘Patients with esophageal cancer often require esophagectomy with esophagogastrostomy.However,the incidence of complications,such as hemorrhage,during operations for esophageal cancer is high,even with minimally invasive surgery.Without the appropriate interventions,the risk of major intraoperative and postoperative hemorrhage is very high in patients with esophageal cancer and hemophilia.We report the case of a 45-year-old man with esophageal cancer and hemophilia B who underwent a successful hybrid,minimally invasive Ivor-Lewis esophagectomy with appropriate perioperative management.
文摘Recent studies have suggested the existence of a patient population with esophageal eosinophilia that responds to proton pump inhibitor therapy.These patients are being referred to as having proton pump inhibitor responsive esophageal eosinophilia(PPI-REE),which is currently classified as a distinct and separate disease entity from both gastroesophageal reflux disease(GERD)and eosinophilic esophagitis(EoE).The therapeutic effect of proton pump inhibitor(PPI)on PPI-REE is thought to act directly at the level of the esophageal mucosa with an anti-inflammatory capacity,and completely independent of gastric acid suppression.The purpose of this manuscript is to review the mechanistic data of the proposed immune modulation/anti-inflammatory role of the PPI at the esophageal mucosa,and the existence of PPI-REE as a distinct disease entity from GERD and EoE.
文摘AIM: To examine the expression of cyclooxygenase-2 (COX-2) and prostaglandin E2 (PGE2) in rat esophageal lesions induced by reflux of duodenal contents.
文摘High resolution manometry(HRM) is a new technology that made important contributions to the field of gastrointestinal physiology. HRM showed clear advan-tages over conventional manometry and it allowed the creation of different manometric parameters. On the other side, conventional manometry is still wild available. It must be better studied if the new technology made possible the creation and study of these parameters or if they were always there but the colorful intuitive panoramic view of the peristalsis from the pharynx to the stomach HRM allowed the human eyes to distinguish subtle parameters unknown or uncomprehend so far and if HRM parameters can be reliably obtained by conventional manometry and data from conventional manometry still can be accepted in achalasia studies. Conventional manometry relied solely on the residual pressure to evaluate lower esophageal sphincter(LES) relaxation while HRM can obtain the Integrated Relaxation Pressure. Esophageal body HRM parameters defines achalasia subtypes, the Chicago classification, based on esophageal pressurization after swallows. The characterization of each subtype is very intuitive by HRM but also easy by conventional manometry since only wave amplitudes need to be measured. In conclusion, conventional manometry is still valuable to classify achalasia according to the Chicago classification. HRM permits a better study of the LES.
文摘目的探讨胸腹腔镜联合微创Ivor-Lewis手术(MIILE)治疗中下段食管癌患者的临床疗效.方法将95例中下段食管癌患者分为行胸腹腔镜+MIILE的MIILE组(43例)和行微创McKeown术(MIME)的MIME组(52例),对比两组围手术期指标、术后并发症、术后疼痛和术后生存率.结果 MIILE组手术时间、术中出血量、术后进食时间、术后住院时间均低于MIME组(P<0.05);两组清扫淋巴结数、淋巴结转移率、R0切除率、术后拔胸管时间比较差异无统计学意义(P>0.05);MIILE组术后并发症总发生率低于MIME组(P<0.05);MIILE组术后1,7d视觉模拟评分法(VAS)均低于MIME组(P<0.05);两组术后14 d VAS评分差异无统计学意义(P>0.05);MIILE组术后1个月生活质量核心量表(QLQ-30)评分高于MIME组(P<0.05),两组复发或转移率、生存率及术后6个月QLQ-30评分差异无统计学意义(P>0.05).结论胸腹腔镜联合MIILE是治疗中下段食管癌安全有效的微创手术,可减少术后并发症,提高患者早期的生活质量.
