Literature around the world

Wang, Kenneth W.
December 2003
American Journal of Gastroenterology;Dec2003, Vol. 98 Issue 12, p2799
Academic Journal
This is an interesting review of the experience of the surgical group at Johns Hopkins University with esophagectomy for patients with Barrett's esophagus with high grade dysplasia. There were a total of 60 patients reported in this review who underwent resection between 1982 and 2001. All of these patients did not have endoscopically identifiable cancer. The article reviewed the surgical principals for treatment of high grade dysplasia, which included the need for histological review of the high grade dysplasia before embarking on any therapy. The authors favored using trans-hiatal esophagectomy because it accessed Ni lymph nodes and guaranteed the ability of the surgeon to achieve a comfortable margin of squamous mucosa above the columnar Barrett's epithelium, and the cervical anastomosis decreased the chance of possible leaks. The study reported that this approach was taken in 82% of their patients. The author compared their experience with Barrett's esophagus between 1982 and 1994 with 30 patients with their experience from 1994 to 2001 in another 30 patients. The patients had similar gender, ethnicity, and ages. Interestingly, the mortality rate in the first 30 patients was 3.3%, but in the most recent period no patients died from the operation. Some of this improvement in mortality seemed to be due to the initiation of a step-wise approach to managing these patients. Another finding was that the incidence of endoscopically occult cancers decreased from 43% in the earlier period to 16.7% in the most recently treated groups. The study concluded that surgical therapy was an option in the management of Banett's esophagus, but that recent studies had demonstrated that the risk of cancer progression may have been overestimated and that endoscopic surveillance should also be considered.


Related Articles

  • Endoscopic methods in the treatment of early-stage esophageal cancer. Kruszewski, Wiesław Janusz // Videosurgery & Other Miniinvasive Techniques / Wideochirurgia i;Jun2014, Vol. 2014 Issue 2, p125 

    Most patients with early esophageal cancer restricted to the mucosa may be offered endoscopic therapy, which is similarly effective, less invasive and less expensive than esophagectomy. Selection of appropriate relevant treatment and therapy methods should be performed at a specialized center...

  • Evidence-Based Selective Application of Transhiatal Esophagectomy in a High-Volume Esophageal Center. Donohoe, Claire; O'Farrell, Naoimh; Ravi, Narayamasamy; Reynolds, John // World Journal of Surgery;Jan2012, Vol. 36 Issue 1, p98 

    Background: Transthoracic esophagectomy (TTE) with lymphadenectomy represents the gold standard of operative approaches to esophageal cancer. The TTE procedure carries significant operative risk, particularly in patients with co-morbidities, and the possible oncologic benefit of a mediastinal...

  • Esophageal cancer patients surviving 6 years after esophagectomy. Tachibana, Mitsuo; Dhar, Dipok; Kinugasa, Shoichi; Yoshimura, Hiroshi; Fujii, Toshiyuki; Shibakita, Muneaki; Ohno, Satoshi; Ueda, Shuhei; Kohno, Hitoshi; Nagasue, Naofumi // Langenbeck's Archives of Surgery;Jun2002, Vol. 387 Issue 2, p77 

    Background. Esophageal cancer is one of the most malignant tumors, with a dismal prognosis in spite of recent advances in early diagnosis and extended lymphadenectomy. These patients need to be stratified according to prognostic variables for precise identification of high-risk group. Material...

  • Forty years’ experience in surgical treatment for esophageal cancer. Kakegawa, Teruo // International Journal of Clinical Oncology;Oct2003, Vol. 8 Issue 5, p277 

    Focuses on the postoperative complications mostly related to operative mortality, anastomotic leakage and pulmonary complications, and on radical esophagectomy and lymphadenectomy, which are essential to improve long-term survival. Introduction of epidural anesthesia during and after...

  • Preoperative risk analysis–a reliable predictor of postoperative outcome after transthoracic esophagectomy? Schröder, W.; Bollschweiler, E.; Kossow, C.; Hölscher, A. H. // Langenbeck's Archives of Surgery;Oct2006, Vol. 391 Issue 5, p455 

    In patients with esophageal carcinoma, transthoracic esophagectomy is associated with high postoperative morbidity and mortality rates. The question of this study was whether an individualized preoperative risk analysis is able to predict postoperative outcome. Based on prospectively accumulated...

  • Tracheobronchial Lesions Following Esophagectomy: Erosions, Ulcers, and Fistulae, and the Predictive Value of Lymph Node-Related Factors. Maruyama, Kiyotomi; Motoyama, Satoru; Sato, Yusuke; Hayashi, Kaori; Usami, Shuetu; Minamiya, Yoshihiro; Ogawa, Jun-ichi // World Journal of Surgery;Apr2009, Vol. 33 Issue 4, p778 

    Following esophagectomy, tracheobronchial lesions (TBLs) can occur as a result of ischemia caused by extensive dissection around the tracheobronchus. In this study we assessed the causes and clinical features of these complications, paying particular attention to lymph node (LN)-related factors....

  • Predicting Early Cancer-related Deaths after Curative Esophagectomy for Esophageal Cancer. MATSUMOTO, SOHEI; TAKAYAMA, TOMOYOSHI; WAKATSUKI, KOHEI; ENOMOTO, KOJI; TANAKA, TETSUYA; MIGITA, KAZUHIRO; ITO, MASAHIRO; NAKAJIMA, YOSHIYUKI // American Surgeon;May2013, Vol. 79 Issue 5, p528 

    Esophagectomy is the primary treatment for esophageal cancers, but a few patients still suffer from early recurrence and die within one year after surgery. The aim of this study was to identify preoperative predictive risk factors for early cancer-related deaths after curative esophagectomy for...

  • Surgical treatment of superficial esophageal cancer. Tachibana, Mitsuo; Kinugasa, Shoichi; Shibakita, Muneaki; Tonomoto, Yasuhito; Hattori, Shinji; Hyakudomi, Ryoji; Yoshimura, Hiroshi; Dhar, Dipok; Nagasue, Naofumi // Langenbeck's Archives of Surgery;Sep2006, Vol. 391 Issue 4, p304 

    The worldwide incidence of superficial esophageal cancer (SEC) is increasing. The aim of this study is to review the systematic surgical outcomes of esophagectomy for SEC. Only manuscripts written in English and written between 1980 and 2003 were selected from MEDLINE. The keywords consisting of...

  • Location of Lymph Node Involvement in Patients with Esophageal Adenocarcinoma Predicts Survival. Talsma, Aaldert; Ong, Chin-Ann; Liu, Xinxue; Hagen, Pieter; Lanschot, Jan; Tilanus, Huug; Hardwick, Richard; Carroll, Nicholas; Spaander, Manon; Fitzgerald, Rebecca; Wijnhoven, Bas // World Journal of Surgery;Jan2014, Vol. 38 Issue 1, p106 

    Background: The location of positive lymph nodes has been abandoned in the seventh classification of the TNM staging system for esophageal adenocarcinoma. The present study evaluates whether distribution of involved nodes relative to the diaphragm in addition to TNM 7 further refines prediction....


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics