[Laparoscopic reconstruction in traumatic rupture of the diaphragm].

The authors report the case of a 63-year-old patient who was polytraumatized in a motor vehicle accident and suffered multiple traumatic injuries. Chest and pelvic fractures as well as left-sided diaphragmatic rupture with associated omentum herniation were diagnosed on CT scan. None of the injuries required urgent surgical intervention.

"Mystic" transient recurrent nerve palsy after thyroid surgery.

Background: The mechanism of transient recurrent laryngeal nerve (RLN) palsy remains unclear.

Methods: Samples were harvested from the RLN adjacent thyroid capsule and perineural fascia during 223 lobectomies and 89 RLNs from cadavers were used for histologic and immunohistologic evaluation. Intraoperative chromoendoscopic features of the RLN were compared with postoperative ear, nose, and throat examinations.

Recurrent, nonmalignant tracheoesophageal fistulas and the need for surgical improvisation.

Background: Despite the many recent advances in thoracic surgery, the management of patients with recurrent, nonmalignant tracheoesophageal fistulas remains problematic, controversial, and challenging.

Methods: Between 1998 and 2008, we treated 8 patients with RTEF. Closure of the original tracheoesophageal fistula had been attempted once in 5 patients, twice in 2 patients, and 4 times in 1 patient, all in different institutions.

Place and value of the recurrent laryngeal nerve (RLN) palpatory method in preventing RLN palsy during thyroid surgery.

Background: In recent years, certain publications have appeared confirming that intraoperative palpation of the recurrent laryngeal nerve (RLN) is a very reliable method.

Method: The characteristics of the surgical anatomy of 1023 RLN have been summarized on the basis of intraoperative palpability, running down, branching variations, thickness, and laryngeal entry site.

Results: Palpation was helpful in 81.

[Celiac artery compression syndrome--stepchild of abdominal angina?].

Background: Celiac trunk compression in few percentages of the cases can cause chronic abdominal pain that shows no connection with eating.

Case Report: Detailed preoperative examinations showed significant, segmental stenosis of the celiac trunk, caused by outer compression of a tendonous arc of diaphragm, in the background of abdominal pain and mesenteric ischemia of a 58-year-old woman. After preparation we have executed the surgery by removing a tight ring, located at around 8-10 mm from the origin of trifurcation, and a part of the celiac ganglion.

Morphological changes in the lower esophageal sphincter influencing the result of antireflux surgical interventions in chronic gastroesophageal reflux disease.

Background/aims: It is still unclear whether long-term reflux episodes result in morphological changes in the lower esophageal sphincter or not. If the answer is supposedly yes, do these changes influence the postoperative functional results following antireflux surgery?

Methodology: Between 1 January 2002 and 2004, we performed antireflux surgery on 85 patients. Muscle samples were taken from the lower esophageal sphincter (LES) in 57 patients on operation.

Significance and prognostic value of lysosomal enzyme activities measured in surgically operated adenocarcinomas of the gastroesophageal junction and squamous cell carcinomas of the lower third of esophagus.

Aim: To establish whether there are fundamental differences in the biochemistries of adenocarcinomas of the gastroesophageal junction (GEJ) and the squamous cell carcinomas of the lower third of the esophagus (LTE).

Methods: Between February 1, 1997 and February 1, 2000, we obtained tissue samples at the moment of resection from 54 patients for biochemical analysis. The full set of data could be comprehensively analyzed in 47 of 54 patients samples (81%).

[Synchronous carcinoma of the esophagus and the thyroid gland].

Introduction: Incidence of synchronous or metachronous carcinomas with primer esophageal malignancy together can be estimated at 17% and these disorders manifest mostly in the stomach.

Case Report: The authors report the medical history of a 55-year-old man whose symptomatic middle third esophageal carcinoma was cured with esophagectomy and two field lymphadenectomy. Stomach was used for substitution.

The place of gastro-jejuno-duodenal interposition following limited esophageal resection.

Objective: Although stomach is the best choice for reconstruction after esophagectomy from the viewpoint of safety and ease, an intrathoracic stomach, nevertheless, is a poor long-term substitute. This anatomical configuration abolishes normal antireflux mechanisms and places the acid-excreting stomach subject to biliary reflux, moreover, in an adjacent position to the esophagus within the negative-pressure environment of the thorax.

Methods: Between 1995 and 2002, 27 patients with high-grade neoplasia-as early Barrett's carcinoma-or non-dilatable peptic stricture underwent limited surgical resection of the distal esophagus and esophagogastric junction.