2011
DOI: 10.1590/s0102-67202011000100007
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Análise das complicações da esofagectomia transmediastinal no tratamento cirurgico do megaesôfago recidivado

Abstract: headings -Esophagectomy. Esophageal ahalasia.abstRact -Background -The best option for the treatment of patients with achalasia and recurrent symptoms after previous treatment, has always been very controversial. In literature review, there is no surgical technique considered the best to deal with this condition. The idea to use a more selective treatment with transmediastinal esophagectomy without thoracotomy in patients with advanced megaesophagus in relapsed cases after prior cardiomyotomy can be considered… Show more

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Cited by 3 publications
(8 citation statements)
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“…Other objective of this described technique is to resect the esophageal mucosa that frequently shows inflammatory findings due to long-term food stasis and brings a risk for malignization between 3% to 10% according to different series [14,15,19] . Cancer was not observed in the resected mucosa in our series but severe inflammation was noticed in all cases and leukoplakia in 15.7%.…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…Other objective of this described technique is to resect the esophageal mucosa that frequently shows inflammatory findings due to long-term food stasis and brings a risk for malignization between 3% to 10% according to different series [14,15,19] . Cancer was not observed in the resected mucosa in our series but severe inflammation was noticed in all cases and leukoplakia in 15.7%.…”
Section: Discussionmentioning
confidence: 99%
“…Pleural and tracheal injury, as well as hemorrhage, may occur during mediastinal dissection due to severe periesophagitis leading to adhesions between the esophagus and mediastinal structures. It is also well known that stasis esophagitis observed in endstage disease predisposes to premalignant lesions or even carcinoma [14][15][16][17] . Based on this premises, the idea of striping the esophageal mucosa and submucosa through cervical and abdominal incisions in the absence of thoracotomy came to mind.…”
Section: History and Indicationsmentioning
confidence: 99%
“…However, in a more critical analysis, it has been demonstrated that this technique is not free from complications. Among them, it can be emphasized pleuromediastinal complications translated to hemomediastinum and hemothorax, which can contribute to great morbidity in the postoperative time 5 , 20 . This can happen, as the advanced megaesophagus presents periesophagitis, making this organ adhere to important structures of the mediastinum, which may predispose lesions during dissection.…”
Section: Discussionmentioning
confidence: 99%
“…As it has been demonstrated by several authors for many years, the best therapy is esophagectomy without thoracotomy 13 , as it acts directly in the physiopathology of this disease, being the transmediastinal technique proposed by Pinotti the most used 5 , 8 , 22 , 23 . More recently with the advent of minimally invasive surgery, this resection can be performed by videolaparoscopy 12 , 29 .…”
Section: Introductionmentioning
confidence: 99%
“…More recently with the advent of minimally invasive surgery, this resection can be performed by videolaparoscopy 12 , 29 . In a more critical analysis; however, it has been demonstrated that transmediastinal esophageal resection is not free from complications which may contribute to greater morbidity in the postoperative 8 , 10 , 19 . This may occur, as the advanced megaesophagus presents periesophagitis leading to the adherence to mediastinal structures predisposing and complications.…”
Section: Introductionmentioning
confidence: 99%