Related Experiment Video
Updated: Jul 28, 2026
An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
Published on: April 17, 2020
[Peptic stenoses of the esophagus]
Abstract:
The authors present a series of 32 cases of reflux peptic strictures of the esophagus. The mean age of the patients is 54 years, with a 3/1 predominance of males. The etiologic antecedent was hiatal hernia in every case, with a clinical time of evolution of 29 months, dysphagia being the most frequent symptom (100%). Complementary diagnosis was based fundamentally on endoscopy and barium transit, explorations that also allow exclusion of other pathologies. All the patients underwent medical treatment, this being the only treatment in 4 cases. The other 28 cases were treated surgically. The technique used was, in the cases in which the esophagus could be dilated, dilatation associated with an antireflux technique, and when not dilatable, resection with reconstruction using stomach (Sweet) or colonoplasty. The global mortality was two patients (5.2%). Patients were followed-up for a minimum of 2 years and the global results have been good, with recurrence in 3 cases (7.7%). Postoperative dysphagia appeared in 17 cases (44.7%), in all of the transitory.
Insights
This study on esophageal strictures found that while surgery is often necessary, good long-term outcomes are achievable with appropriate antireflux techniques. Recurrence rates were low, with most postoperative dysphagia being temporary.
Area of Science:
- Gastroenterology and Surgery
- Esophageal Diseases
- Peptic Strictures
Context:
- Reflux peptic strictures of the esophagus are a significant cause of morbidity.
- Hiatal hernia is a consistent etiologic factor.
- Dysphagia is the predominant symptom, impacting quality of life.
Purpose:
- To analyze the outcomes of medical and surgical management for reflux peptic esophageal strictures.
- To evaluate the efficacy of different surgical techniques, including dilatation with antireflux procedures and resection with reconstruction.
- To assess long-term results, recurrence rates, and complications.
Summary:
- A series of 32 patients with reflux peptic esophageal strictures, predominantly male (3/1 ratio) with a mean age of 54, were studied.
- All cases were associated with hiatal hernia; dysphagia was universal. Diagnosis relied on endoscopy and barium transit.
- Treatment involved medical management (4 cases) or surgery (28 cases) using dilatation/antireflux techniques or resection/reconstruction (Sweet or colonoplasty).
Impact:
- The study reports a global mortality of 5.2% and a recurrence rate of 7.7% over a minimum 2-year follow-up.
- Surgical interventions demonstrated good global results, highlighting the effectiveness of tailored approaches.
- Transient postoperative dysphagia occurred in 44.7% of surgical patients, indicating a manageable short-term complication.
Related Concept Videos
01:21Barrett Esophagus-II: Clinical Manifestations and Management
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure entails...
01:30Esophageal Strictures-I: Introduction
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...
01:26Esophageal Strictures-II: Clinical Features and Management
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
01:30Peptic Ulcer Disease I: Introduction
An acute ulcer, marked by superficial erosion and minimal inflammation, swiftly resolves upon identifying and addressing the underlying cause. In contrast, a chronic ulcer persists, potentially eroding through the muscular wall and forming fibrous tissue.
Peptic ulcers can also be...
01:27Esophageal Achalasia
01:25Gastroesophageal Reflux Disease