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Related Concept Videos

Esophageal Strictures-II: Clinical Features and Management01:26

Esophageal Strictures-II: Clinical Features and Management

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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...
216
Esophageal Strictures-I: Introduction01:30

Esophageal Strictures-I: Introduction

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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...
350
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy

252
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
252
Esophageal Perforation-II: Clinical Manifestations and Management01:28

Esophageal Perforation-II: Clinical Manifestations and Management

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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:
211
Esophageal Perforation-I: Introduction01:22

Esophageal Perforation-I: Introduction

225
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....
225
Esophageal Varices-II: Clinical Features and Management01:28

Esophageal Varices-II: Clinical Features and Management

205
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...
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Updated: Nov 4, 2025

An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
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[Reconstructive esophageal surgery in fast track epoch].

A L Shestakov1, I A Tarasova1, A T Tskhovrebov1

  • 1Petrovsky Russian Scientific Center of Surgery, Moscow, Russia.

Khirurgiia
|May 25, 2021
PubMed
Summary

Fast track management in esophageal surgery significantly reduces hospital and intensive care unit (ICU) stays. This enhanced perioperative care protocol also lowers the incidence of respiratory complications like pneumonia.

Keywords:
enhanced recovery after surgeryesophageal resectionesophagoplastyfast trackpostoperative rehabilitation

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Area of Science:

  • Surgical Oncology
  • Gastroenterology
  • Critical Care Medicine

Background:

  • Reconstructive esophageal surgery is a complex procedure with significant postoperative recovery implications.
  • Optimizing perioperative care is crucial for improving patient outcomes and reducing healthcare resource utilization.
  • Traditional perioperative management may lead to prolonged hospital stays and higher complication rates.

Purpose of the Study:

  • To evaluate the efficiency and safety of a perioperative fast track management protocol in patients undergoing reconstructive esophageal surgery.
  • To compare outcomes between patients managed with the fast track protocol and those receiving traditional perioperative care.

Main Methods:

  • A retrospective study comparing patients managed with a fast track protocol (2017-2020, n=75) against a control group receiving traditional care (2010-2013, n=63).
  • Key outcomes assessed included postoperative hospital stay, intensive care unit (ICU) stay, complication incidence (Clavien-Dindo grading), mortality, and feeding onset.
  • No significant differences were observed in baseline demographics (sex, age, ASA grade, BMI) between the groups.

Main Results:

  • Fast track management significantly reduced mean hospital stay from 14 days (control) to 11 days (fast track, p=0.008).
  • Mean ICU stay decreased substantially from 4.1 days (control) to 1 day (fast track, p<0.0001).
  • The incidence of pneumonia was lower in the fast track group (5 patients) compared to the control group (15 patients, p=0.004), with no mortality in the fast track group versus 4.8% in the control group.

Conclusions:

  • The perioperative fast track management protocol is a safe and effective approach for extensive reconstructive esophageal interventions.
  • This protocol leads to significant reductions in overall hospital stay and ICU utilization.
  • Fast track management is associated with a decreased incidence of critical respiratory complications post-esophageal surgery.