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Related Concept Videos

Esophageal Strictures-I: Introduction01:30

Esophageal Strictures-I: Introduction

35
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...
35
Esophageal Strictures-II: Clinical Features and Management01:26

Esophageal Strictures-II: Clinical Features and Management

18
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...
18
Barrett Esophagus-I: Introduction01:21

Barrett Esophagus-I: Introduction

35
Barrett's esophagus is a medical condition where the esophageal mucosa is significantly damaged by stomach acid or other digestive fluids, often due to long-term exposure associated with gastroesophageal reflux disease (GERD). In GERD, a weakened or abnormally relaxed lower esophageal sphincter allows stomach acid to flow persistently into the esophagus.
This constant acid exposure transforms the esophagus's pink mucosal lining (stratified squamous epithelium) into a type of lining more...
35
Esophageal Varices-I: Introduction01:24

Esophageal Varices-I: Introduction

45
Esophageal varices are dilated, tortuous veins which are found mainly in the submucosa of the lower esophagus but which may also appear higher up or extend into the stomach. They develop due to increased pressure in the portal venous system, often as a result of liver cirrhosis. This condition scars and damages the liver, impeding normal blood flow through the portal vein. To compensate, blood seeks alternative pathways, forming fragile new vessels (varices) in the esophagus and stomach. These...
45
Barrett Esophagus-II: Clinical Manifestations and Management01:21

Barrett Esophagus-II: Clinical Manifestations and Management

71
Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
71
Esophageal Perforation-I: Introduction01:22

Esophageal Perforation-I: Introduction

40
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....
40

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Related Experiment Video

Updated: May 8, 2025

An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
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An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function

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Risk Factors for Benign Anastomotic Stenosis After Esophagectomy for Cancer.

Dillen C van der Aa1,2,3, Jelle Boonstra4, Wietse J Eshuis4,5,6

  • 1Department of Surgery, Amsterdam UMC, Location University of Amsterdam, Amsterdam, The Netherlands. d.c.vanderaa@amsterdamumc.nl.

Annals of Surgical Oncology
|May 6, 2025
PubMed
Summary

Benign anastomotic stenosis after esophagectomy is linked to anastomotic leakage and specific surgical techniques. Risk factors like immunosuppressants and chronic pulmonary disease increase stenosis occurrence, impacting patient quality of life.

Keywords:
BenignEsophagectomyStenosisStricture

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Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Thoracic Surgery

Background:

  • Benign anastomotic stenosis is a common complication following esophagectomy, leading to dysphagia and reduced quality of life.
  • Identifying risk factors for benign anastomotic stenosis is crucial for improving patient outcomes after esophagectomy for cancer.

Purpose of the Study:

  • To identify predictive factors associated with the development of benign anastomotic stenosis after esophagectomy for cancer.
  • To analyze risk factors separately for intrathoracic and cervical anastomoses.

Main Methods:

  • Retrospective cohort study of 902 patients undergoing esophagectomy between 2012 and 2022.
  • Analysis of intrathoracic and cervical anastomoses, defining stenosis by dysphagia and need for dilation.
  • Logistic regression was used to identify predictive factors for stenosis.

Main Results:

  • Higher stenosis rates were observed in cervical (49.8%) compared to intrathoracic (18.4%) anastomoses (p < 0.001).
  • Intrathoracic stenosis was associated with anastomotic leakage (OR, 2.034), smaller stapler size (OR, 0.486), immunosuppressants (OR, 3.492), and chronic pulmonary disease (OR, 2.717).
  • For cervical anastomoses, hand-sewn end-to-side technique was protective (OR, 0.454), while immunosuppressants and COPD increased risk.

Conclusions:

  • Key risk factors for intrathoracic stenosis include anastomotic leakage, smaller stapler size, immunosuppressant use, and chronic pulmonary disease.
  • For cervical anastomoses, hand-sewn end-to-side technique is protective, whereas immunosuppressants and chronic pulmonary disease elevate stenosis risk.