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
3.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
4.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
5.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
7.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
8.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
9.Multiple Embolic Infarcts Caused by Infective Endocarditis Associated with Atrioesophageal Fistula after Percutaneous Radiofrequency Catheter Ablation for Atrial Fibrillation
Yu Jin KOO ; Jae Wook JUNG ; Chan Wook PARK ; Woo Seok HA ; Bo Kyu CHOI ; Hye Yoon CHUNG ; Hyun Ji LYOU ; In Gun HWANG ; Young Dae KIM ; Ji Hoe HEO ; Hyo Suk NAM
Journal of the Korean Neurological Association 2019;37(2):166-170
Infective endocarditis (IE) is not a common cause of stroke. Considering the high mortality rates, however, IE should always be considered as a possible cause of stroke even when the chances are low. Atrioesophageal fistula is a life-threatening condition that can cause IE and subsequent stroke, but the diagnosis is often delayed due to its rarity. We report a case of multiple embolic infarcts caused by infective endocarditis associated with atrioesophageal fistula after radiofrequency catheter ablation for atrial fibrillation.
Atrial Fibrillation
;
Catheter Ablation
;
Diagnosis
;
Endocarditis
;
Esophageal Fistula
;
Fistula
;
Mortality
;
Stroke
10.Efficacy of the Over-the-Scope Clip System for Treatment of Gastrointestinal Fistulas, Leaks, and Perforations: A Korean Multi-Center Study
Hang Lak LEE ; Joo Young CHO ; Jun Hyung CHO ; Jong Jae PARK ; Chan Gyoo KIM ; Seong Hwan KIM ; Joung Ho HAN
Clinical Endoscopy 2018;51(1):61-65
BACKGROUND/AIMS: Currently, a new over-the-scope clip (OTSC) system has been introduced. This system has been used for gastrointestinal perforations and fistulas in other countries. The aim of our study is to examine the therapeutic success rate of endoscopic treatment using the OTSC system in Korea. METHODS: This was a multicenter prospective study. A total of seven endoscopists at seven centers performed this procedure. RESULTS: A total of 19 patients were included, with gastrointestinal leakages from anastomosis sites, fistulas, or esophageal perforations due to Boerhaave’s syndrome. Among these, there were three gastrojejunostomy sites, three esophagojejunostomy sites, four esophagogastrostomy sites, one esophagocolonostomy site, one jejuno-jejunal site, two endoscopic full thickness resection site closures, one Boerhaave’s syndrome, two esophago-bronchial fistulas, one gastrocolonic fistula, and one colonopseudocyst fistula. The size of the leakage ranged from 5 to 30 mm. The median procedure time was 16 min. All cases were technically successful. Complete closure of the leak was achieved in 14 of 19 patients using OTSC alone. CONCLUSIONS: The OTSC system is a safe and effective method for the management of gastrointestinal leakage, especially in cases of anastomotic leakage after surgery.
Anastomotic Leak
;
Esophageal Perforation
;
Fistula
;
Gastric Bypass
;
Humans
;
Korea
;
Methods
;
Prospective Studies

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