Quality of Life in patients with resected oesophageal cancer.

Quality of Life (QL) is hard to assess and seldom measured in patients having carcinomas with an unfavourable prognosis. Oesophageal cancer is one of the malignancies with a low 5-year survival rate. Dysphagia (problems in swallowing food) is considered to be the most important indicator of QL in patients with oesophageal carcinoma.

An unusual cause of acute appendicitis.

A case is presented of a patient with a metastasis of cardia carcinoma to the appendix, causing acute appendicitis. Survey of the literature shows that metastasis to the appendix is very rare. When present, it is likely to be the cause of appendicitis by obstruction of the lumen.

A modified pectoralis muscle flap for closure of postpneumonectomy esophagopleural fistula: technique and results.

In surgical treatment of late postpneumonectomy esophagopleural fistula, closure of the empyema space is of prime importance. A wide thoracoplasty and ample decapitation of the empyema cavity allow sufficient room for a modified pectoralis muscle flap, which provides sufficient mass to obliterate the entire empyema cavity. We present the cases of 2 patients in whom an esophagopleural fistula occurring 3 and 16 years after pneumonectomy was successfully closed by this method.

Survival after resection for carcinoma of the oesophagus.

During the period 1978-1984, 525 patients referred with cancer of the oesophagus or gastro-oesophageal junction were assessed for operation and cure. After investigation, 276 patients were selected and operated upon, as a rule, 4 weeks after radiotherapy (40 Gy/4 weeks). In 224 patients (81 per cent) the oesophagus and cardia were resected and reconstructed with stomach (69 per cent), colon (21 per cent), free ileal graft (7 per cent) or Roux-en-Y-oesophagojejunostomy (3 per cent).

Therapy of esophageal carcinoma. Results from the Joint Group on Esophageal Carcinoma in Rotterdam.

During the period 1978-1981 172 patients were referred to the Rotterdam Joint Group on Esophageal Carcinoma. Ninety-one patients were considered for combined therapy, comprising radiation therapy and surgery, and 10 patients refused surgery. The figures given in this material are actuarial survival values corrected for intercurrent death (the actuarial overall survival in parentheses).

Carcinoma of the esophagus: treatment results.

Of the 172 patients with carcinoma of the esophagus or the gastro-esophageal junction seen between January 1978 and January 1981, 69 patients had combined treatment, radiotherapy and resection, and 38 had curative radiotherapy. The remaining 65 were treated palliatively. The 4-year actuarial survival of the first two treatment groups was respectively 40% and 4%.

Mural collagen in experimental reflux esophagitis in rats.

Changes in the collagen content of the esophageal wall in reflux esophagitis were studied in rats subjected to surgically induced and biochemically monitored pancreaticobiliary reflux into the esophagus. Reflux periods of 7, 14, 28, and 42 days were followed by a reflux-abolishing operation, which resulted in healing of the esophagitis. The collagen content of the esophageal wall at the end of the reflux period was higher than control values obtained from normal nonoperated rats, with a significant difference after 42 days of reflux.

A plea for conservative treatment of large, unruptured omphaloceles.

Forty-six babies with an unruptured omphalocele were admitted over a 10-year period. The conservative treatment consisted of the application of mercurochrome or an antibiotic powder, while the primary surgical treatment consisted of either full-layer closure or silastic sac insertion. Liver containing omphaloceles were considered large.

Active trypsin and reflux oesophagitis: an experimental study in rats.

In order to clarify the role of active trypsin, bile acids and pepsin in reflux oesophagitis, a comparable series of experiments was performed in rats before and after reflux-inducing operations. Three control procedures were used--laparotomy (n = 10), oesophageal transection and reanastamosis (n = 7) and a Roux-en-Y reconstruction (n = 9)--and seven experimental procedures in order to produce gastric, bile and pancreatic reflux (G + B + P) (n = 9), gastric and pancreatic reflux (B + B) (n = 8), bile and pancreatic reflux (B + P) (n = 10), pancreatic reflux alone (P) (n = 9), gastric reflux alone (G) (n = 8), bile reflux alone (B) (n = 9) and gastric with bile reflux (G + B) (n = 9). Macroscopic and histologically confirmed oesophagitis was produced in groups G + B + P, G + P, B + P and P.

Gastroschisis: factors affecting prognosis.

Over a ten-year period 21 children with gastroschisis were treated either with a direct full-layer closure or with a silastic sac closure of the abdominal wall defect. No mortality or longterm morbidity resulted from either form of therapy in the group of patients that had no anatomical interruption of the gastro-intestinal tract. Silastic sac closure did, however, result in a higher incidence of septicemia.