The clinical presentation of Boerhaave’s syndrome (BS), a rare condition of the gastrointestinal tract characterized by a spontaneous rupture of the esophagus most often caused by vomiting after excessive alcohol drinking or after consuming a large meal, mimics other less serious illnesses, often leading to a missed or delayed diagnosis. The Mackler triad, which is rare and pathognomonic of BS, includes lower thoracic or chest pain, subcutaneous emphysema, and vomiting. Diagnosis is made through computed tomography scan and esophageal contrast studies. Treatment of BS is geared towards control of mediastinitis and sepsis, and repair of the perforation or reestablishment of the continuity of the gastrointestinal tract. We report the case of a 46-year-old male with BS, who was initially managed with a conservative resection of the perforated esophagus 48 hours after the onset of symptoms. When the mediastinitis persisted we decided to do a subtotal esophagectomy and subsequent esophageal reconstruction.
Esophagectomy

No abstract available.
Esophagectomy* ; Stomach*

Background: Esophageal cancer is a common disease at Digestive Surgery Department of Binh Dan hospital. Surgical treatment is still a main procedure. Objectives: Study on a less invasive surgical technique in esophagectomy with supported thoracoscopy to provide a new esophageal cancer treatment. Subjects and method: Application on a new technique via thoracoscopy to esophagectomy totally in 6 patients (1 female, 5 males), aged 60 years on average, treated in Digestive Surgery Department of Binh Dan hospital from March 2006 to June 2006. Results: The average surgical time was 260 minutes. There was no event during operation. Postoperative complications included: 1 patient had to stitch abdominal wall after operative 7 days, 3 patients with pneumonia after successful operation, 2 patients with right pneumothorax, having to put siphonage. There was one case of death without related to operative technique. Conclusion: Esophagectomy is major operation that can be conducted via open surgery or laparoscopic surgery. Although small case studies, researchers found that laparoscopic surgery is a feasible technique, can be performed safely if the surgeons having experience in open surgery and good skills on laparoscopic surgery. However, thoracoscopic esophagectomy can only be considered as a surgical method, without an alternative method to traditional open surgery.
Esophagectomy ; Esophageal Neoplasms/surgery ; Thoracoscopy ;

Esophagectomy can result in various postoperative nutrition-related complications that may impair the nutritional status of the patient. In our institution, we usually initiate 16-hour continuous jejunostomy feeding using an enteral feeding pump on postoperative day 2 as a routine protocol after esophagectomy. The target calorie intake was achieved in 6-7 days with this protocol, which is longer than that required with other recently reported feeding protocols. Accordingly, early jejunostomy feeding protocol, which starts on postoperative day 1 and continues for 24 hours was attempted. In the present report, we described 3 cases of early 24-hour continuous jejunostomy feeding after esophagectomy. The use of this new protocol reduced the duration required to achieve the target calorie intake as less than 5 days without any enteral feeding-related complications.
Enteral Nutrition ; Esophagectomy* ; Humans ; Jejunostomy* ; Nutritional Status

Previous studies reported that ultrathin endoscope (UE) provides endoscopic guidance during insertion of a self-expanding metal stent (SEMS) without fluoroscopic monitoring in patients with upper gastrointestinal stenosis (benign or malignant) or postoperative esophageal leakage. According to the type of SEMS and level of the stenosis, the technique of the procedure is variable. Herein, we report a patient who underwent placement of a distal release esophageal SEMS to treat an esophagogastric anastomotic stricture via retroflexed UE.
Constriction, Pathologic* ; Endoscopes ; Endoscopy* ; Esophagectomy ; Humans ; Stents*

Esophagectomy is the major treatment for a variety of esophagus diseases. However, despite its wide applications, it is also one of the highest-risk procedures. Thus, reduction of mortality and complication after esophagectomy has drawn much attention, and the definition, classification and prediction of complication following esophagectomy is of vital importance. Unfortunately, there is no unified definition and specific prediction system for complications of esophagectomy until now. We review the advances in complication research in order to offer references to reduce mortality, prevent or treat complications of this high-risk operation.
Esophageal Diseases ; surgery ; Esophagectomy ; adverse effects ; Humans

Benign gastrobronchial fistula (GBF) after Ivor Lewis operation is a very rare and serious complication. We describe a patient with GBF who was successfully managed on the single-stage repair, 15 months after the Ivor Lewis operation. After the division of the GBF, the bronchial and gastric defects were closed directly. The omental flap and the pedicled 5th. intercostal muscle flap were interposed between the closed defects. The literature of this subject is reviewed and discussed.
Esophageal Neoplasms ; Esophagectomy* ; Fistula* ; Gastric Fistula ; Humans ; Intercostal Muscles

Surgery remains the cornerstone of treatment for esophageal cancer, although improvements have been made in surgical maneuvers and perioperative care, serious complications still occur after operation. The reconstruction of alimentary tract is a key procedure to ensure success of operation, it is related to perioperative complication and prognosis. Selection of procedure should be individualized based on the stage and location of the disease, medical condition and the surgeon's experience.
Anastomosis, Surgical ; methods ; Esophageal Neoplasms ; surgery ; Esophagectomy ; methods ; Humans

Analgesia, Epidural ; methods ; Esophagectomy ; methods ; Humans ; Male ; Middle Aged

Esophagectomy is one of the most complicated procedures. Satisfactory anesthesia not only ensures the safety in terms of low morbidity and mortality postoperatively, but also one of the potential factors relevant to long-term survival. Most of physicians, however, ignore the significance of anesthesia. This article focuses on the recent advances of anesthesia for esophagectomy in preoperative preparation for induction, rapid-sequence induction, one-lung ventilation, fluid management during surgery and postoperative early extubation and analgesia.
Analgesia ; Anesthesia ; methods ; Esophagectomy ; methods ; Fluid Therapy ; Humans