New approach to malignant strictures of the esophagus

Abstract

Primary esophageal cancer is the most common cause of malignant esophageal stricture. Prognosis and treatment outcomes vary with the stage of the disease. Endoscopic ultrasound has a high accuracy rate for local and regional staging. Surgery is curative for early cancer. Endoscopic mucosal resection, photodynamic therapy, or brachytherapy can be used with curative intent for early cancer, especially in patients with comorbid conditions precluding surgery. Unfortunately, the majority of patients with esophageal cancer present with advanced disease. The primary aim in these patients is to alleviate symptoms with a minimum of side effects and reinterventions. Palliative surgery or chemoradiotherapy can be associated with high morbidity and mortality rates. Several endoscopic techniques for palliation are available, and all have the potential of significantly improving swallowing. The choice of a particular endoscopic approach is usually determined by local expertise and characteristics of the stricture.

Clinical Study of only One Stage Esophagoplasty by using Jejunum with Esophageal Stricture

“…In the sec phase of esophagus-mobilized intestine anastomosis, •in case of high-level lemostenosis, left thyroid cartilage is resected 1cm in width and pharyngoesophagus and mobilized intestine are anastomosed, esophagus and mobilized intestine are incised horizontally at the anastomosis site, and caecus is cut. [4,7] 3. In the third phase of gastrointestinal anastomosis, anastomosis site is selected to the more physiological position, gastric fistula is preserved so that postoperative endogastric pressure is lowered and incidence of complication is decreased, methods of jejunal stump to stump anastomosis and bending fixation of deferent angle are designed newly to shorten the treatment period, decrease the incidence of complication, and to improve the function of artificial esophagus.…”