1.Prevention and treatment of postoperative complications of esophageal cancer.
Chinese Journal of Gastrointestinal Surgery 2023;26(4):330-333
Surgery is the primary treatment for esophageal cancer, but the postoperative complication rate remains high. Therefore, it is important to prevent and manage postoperative complications to improve prognosis. Common perioperative complications of esophageal cancer include anastomotic leakage, gastrointestinal tracheal fistula, chylothorax, and recurrent laryngeal nerve injury. Respiratory and circulatory system complications, such as pulmonary infection, are also quite common. These surgery-related complications are independent risk factors for cardiopulmonary complications. Complications, such as long-term anastomotic stenosis, gastroesophageal reflux, and malnutrition are also common after esophageal cancer surgery. By effectively reducing postoperative complications, the morbidity and mortality of patients can be reduced, and their quality of life can be improved.
Humans
;
Quality of Life
;
Postoperative Complications/prevention & control*
;
Anastomotic Leak/etiology*
;
Esophageal Neoplasms/surgery*
;
Prognosis
;
Esophagectomy/adverse effects*
;
Digestive System Fistula/surgery*
;
Retrospective Studies
2.Clinical characteristics and serious complications of esophageal button battery ingestion in the pediatric on 83 cases.
Feng Zhen ZHANG ; Qing Chuan DUAN ; Gui Xiang WANG ; Xiao Jian YANG ; Wei ZHANG ; Jing ZHAO ; Hua WANG ; Hong Bin LI ; Xin NI ; Jie ZHANG
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2023;58(5):481-485
Objective: To analyze the clinical characteristics and complications of esophageal foreign bodies of button battery ingestion in children. Methods: A retrospective descriptive study included 83 children who were hospitalized in our hospital on account of button battery ingestion from January 2011 to December 2021. There were 50 males (60.2%) and 33 females (39.8%). The age ranged from 7.6 months to one month off 10 years, with a median age of 18 months. The data of patient demographics and time from ingestion to admission, location, symptoms, management, complications, and follow-up outcome were recorded. SPSS17.0 software was used for statistical analysis. Results: Seventy-two children (86.7%) were younger than 3 years old. The time from ingestion to admission ranged from 1 h to 2 months, with a median time of 8 h. Among the 63 children who were first diagnosed in our hospital, the most common clinical symptoms were nausea and vomiting (32 cases, 50.8%), dysphagia (31 cases, 49.2%), salivation (11 cases, 17.5%) and fever (10 cases, 15.9%). Seventy-three of 83 cases had complete preoperative diagnostic tests, and 55 cases (75.3%) were diagnosed by X-ray. In 56 cases (76.7%), the foreign badies were impacted in the upper third of esophagus. In 72 cases (86.7%), the foreign badies were removed by rigid esophagoscopy. 23 (27.7%) had serious complications, including tracheoesophageal fistula in 15 cases(TEF;65.2%), vocal cord paralysis (VCP;34.8%) in 8 cases, esophageal perforation in 3 cases (EP;13.0%), hemorrhage in 3 cases(13.0%), mediastinitis in 3 cases (13%), and periesophageal abscess in 1 case (4.3%). There were significant differences in the exposure time of foreign bodies and unwitnessed ingestion by guardians in the complications group (P<0.05). 2 cases died (2.4%)respectively due to arterial esophageal fistula bleeding and respiratory failure caused by stent displacement during the treatment of tracheoesophageal fistula. Conclusion: Accidental button battery ingestion can be life-threatening. and it mostly happens in children under 3 years old. Serious complications may happen cause of non-specific clinical manifestations and unwitnessed ingestions. Anterior and lateral chest X-ray is the first examination choice. Tracheoesophageal fistula is the most common serious complication.
Male
;
Female
;
Child
;
Humans
;
Infant
;
Child, Preschool
;
Tracheoesophageal Fistula/etiology*
;
Retrospective Studies
;
Foreign Bodies/diagnosis*
;
Eating
6.Effect of muscle relaxants on the prognosis of neonates with congenital esophageal atresia-tracheoesophageal fistula after surgery.
Wen-Wen HE ; Jing-Wen WENG ; Shi-Xiao DONG ; Fei JIN ; Hai-Lan WU ; Ming-Yan HEI
Chinese Journal of Contemporary Pediatrics 2021;23(7):735-738
OBJECTIVE:
To summarize the experience in the application of muscle relaxants in the perioperative period in neonates with congenital esophageal atresia-tracheoesophageal fistula (EA-TEF).
METHODS:
A retrospective analysis was performed on the medical data of 58 previously untreated neonates with EA-TEF who were treated in the Neonatal Center of Beijing Children's Hospital, Capital Medical University from 2017 to 2019. The incidence rate of anastomotic leak was compared between the neonates receiving muscle relaxants for different durations after surgery (≤ 5 days and > 5 days). The correlation between the duration of postoperative use of muscle relaxants and the duration of mechanical ventilation was evaluated.
RESULTS:
Among the 58 neonates with EA-TEF, 44 underwent surgery, among whom 35 with type III EA-TEF underwent thoracoscopic surgery. Among these 35 neonates, 30 (86%) received muscle relaxants after surgery, with a median duration of 4.75 days, and 6 (18%) experienced anastomotic leak. There was no significant difference in the incidence rate of anastomosis leak between the ≤ 5 days and > 5 days groups (
CONCLUSIONS
Prolonged use of muscle relaxants after surgery cannot significantly reduce the incidence of anastomotic leak, but can prolong the duration of invasive mechanical ventilation in neonates with EA-TEF. Therefore, prolonged use of muscle relaxants is not recommended after surgery.
Child
;
Esophageal Atresia/surgery*
;
Humans
;
Infant, Newborn
;
Muscles
;
Postoperative Complications/etiology*
;
Prognosis
;
Retrospective Studies
;
Tracheoesophageal Fistula/surgery*
;
Treatment Outcome
8.A Large Epiphrenic Esophageal Diverticulum Communicating with the Left Lower Lobe
The Korean Journal of Thoracic and Cardiovascular Surgery 2019;52(1):40-43
Epiphrenic diverticula are known to cause a series of complications. We report the case of a 54-year-old woman who was diagnosed with an epiphrenic diverticulum at a regular checkup in November 2006. Ten years later, she presented with massive hematemesis. Imaging studies revealed an epiphrenic diverticulum measuring 7.8 cm in diameter and a large amount of bleeding inside the diverticulum. Computed tomography showed fistula formation between the diverticulum and the left lower lobe of the lung, leading to the development of a pulmonary abscess. Diverticulectomy and 180° posterior partial fundoplication were performed transabdominally. The pulmonary abscess was treated with antibiotics alone. She was discharged 16 days after the operation without any complications over 7 months of follow-up.
Anti-Bacterial Agents
;
Diverticulum
;
Diverticulum, Esophageal
;
Female
;
Fistula
;
Follow-Up Studies
;
Fundoplication
;
Hematemesis
;
Hemorrhage
;
Humans
;
Lung
;
Lung Abscess
;
Middle Aged
9.Guidelines of Esophageal Stent Insertion for Benign and Malignant Diseases
Joon Sung KIM ; Byung Wook KIM
The Korean Journal of Gastroenterology 2019;74(4):197-198
Esophageal stents are used frequently to treat a wide variety of esophageal diseases. The indications for esophageal stent placement can be divided into malignant and benign conditions. Recent data support the utilization of esophageal stents for the treatment of malignant or benign strictures. They are also being used increasingly for the sealing and treatment of esophageal leaks, fistulas, and perforations. On the other hand, stent placement is also associated with complications, such as migration, chest pain, hemorrhage, and perforation. Therefore, it is essential to know the precise indications of stent insertion. This article reviews the recent guidelines for esophageal stent insertion.
Chest Pain
;
Constriction, Pathologic
;
Esophageal Diseases
;
Esophagus
;
Fistula
;
Hand
;
Hemorrhage
;
Stents
10.Congenital Esophageal Atresia Associated with a Tracheobronchial Remnant
The Korean Journal of Thoracic and Cardiovascular Surgery 2019;52(3):170-173
A rare case of esophageal atresia/tracheo-esophageal fistula (EA-TEF) with an associated tracheobronchial remnant (TBR) is reported and discussed herein. A 13-month-old patient was seen with a complaint of vomiting of solid food 1 year after EA-TEF repair. An esophagogram showed a tapered narrowing in the lower segment of the esophagus. A re-operation was carried out and a pathologic examination of the resected stenotic segment revealed the presence of a TBR.
Esophageal Atresia
;
Esophageal Stenosis
;
Esophagus
;
Fistula
;
Humans
;
Infant
;
Vomiting

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