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Related Concept Videos

Esophageal Strictures-II: Clinical Features and Management01:26

Esophageal Strictures-II: Clinical Features and Management

Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
Esophageal Perforation-II: Clinical Manifestations and Management01:28

Esophageal Perforation-II: Clinical Manifestations and Management

Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Esophageal Strictures-I: Introduction01:30

Esophageal Strictures-I: Introduction

Esophageal strictures involve abnormal narrowing or tightening of the esophagus. They vary in length and severity, ranging from mild constriction to complete obstruction, and are classified as benign (noncancerous) or malignant (cancerous).
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
Esophageal Varices-II: Clinical Features and Management01:28

Esophageal Varices-II: Clinical Features and Management

Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol abuse, or...
Endoscopic Studies II: Thoracocentesis01:26

Endoscopic Studies II: Thoracocentesis

Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
Esophageal Perforation-I: Introduction01:22

Esophageal Perforation-I: Introduction

Esophageal perforation is a severe medical condition characterized by a breach in the integrity of the esophageal wall. This breach can occur due to various factors such as trauma, medical procedures, or underlying diseases. When the esophageal wall is compromised, it allows food, fluids, and digestive juices into the chest cavity or adjacent structures, leading to potential complications and health risks.
The location of esophageal perforation can vary, occurring anywhere along the esophagus.

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Related Experiment Video

Updated: Jul 12, 2026

Low-Cost Single-Port (LoCoSP) Device for a Transcervical Approach in Minimally Invasive Transhiatal Esophagectomy
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Two thousand transhiatal esophagectomies: changing trends, lessons learned.

Mark B Orringer1, Becky Marshall, Andrew C Chang

  • 1Section of General Thoracic Surgery, Department of Surgery, University of Michigan Medical Center, Ann Arbor, Michigan 48109, USA. morrin@umich.edu

Annals of Surgery
|August 25, 2007
PubMed
Summary

Transhiatal esophagectomy (THE) is a versatile procedure for esophageal resection. Refinements over 30 years have significantly reduced mortality and morbidity, improving patient outcomes and hospital stays.

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Area of Science:

  • Thoracic surgery
  • Gastrointestinal surgery
  • Surgical oncology

Background:

  • Transhiatal esophagectomy (THE), rediscovered in 1976, is a widely applicable technique for esophageal resection and reconstruction.
  • This study reviews a 30-year single-institution experience with THE, analyzing trends and outcomes.

Purpose of the Study:

  • To evaluate the long-term outcomes and evolving trends of transhiatal esophagectomy (THE) over three decades.
  • To assess the impact of procedural refinements on morbidity and mortality associated with esophageal resection.

Main Methods:

  • Retrospective analysis of a prospective Esophagectomy Database from a single institution.
  • Comparison of outcomes between two distinct time periods (1976-1998 and 1998-2006) encompassing 2007 THE procedures.

Main Results:

  • Hospital mortality decreased significantly from 4% to 1% (P < 0.001).
  • Key improvements included reduced mean blood loss (677 vs. 368 mL) and lower anastomotic leak rates (14% vs. 9%).
  • Early discharge within 10 days increased from 52% to 78%, with 50% discharged within one week in the later period.

Conclusions:

  • Refinements in transhiatal esophagectomy (THE) have substantially decreased historical morbidity and mortality.
  • Consistent technique and clinical pathway management are crucial for high-acuity esophageal surgery patients.