Unusual Surgical Repair of Bronchoesophageal Fistula Following Esophagectomy.

Radical esophagectomy remains the only potentially curative option in the treatment of esophageal cancer. However, this procedure is burdened with high morbidity and mortality rates, even in high-volume centers. A tracheo- or bronchoesophageal fistula (TBF) is rare but is one of the most difficult life-threatening complications following an esophagectomy for cancer treatment.

Markers of Epithelial-Mesenchymal Transition and Mucinous Histology Are Significant Predictors of Disease Severity and Tumor Characteristics in Early-Onset Colorectal Cancer.

Approximately 20% of patients with colorectal cancer (CRC) are diagnosed with a mucinous subtype of this tumor, have a worse prognosis, and often show resistance to available therapies. Molecules from the mucin family are involved in the regulation of epithelial-mesenchymal transition (EMT), which significantly determines the cancer aggressiveness. This study aimed to examine the diagnostic and prognostic significance of mucinous histology and EMT markers in patients with early-onset CRC and their association with disease severity and tumor characteristics.

The Utility of Conventional CT, CT Perfusion and Quantitative Diffusion-Weighted Imaging in Predicting the Risk Level of Gastrointestinal Stromal Tumors of the Stomach: A Prospective Comparison of Classical CT Features, CT Perfusion Values, Apparent Diffusion Coefficient and Intravoxel Incoherent Motion-Derived Parameters.

Background: The role of advanced functional imaging techniques in prediction of pathological risk categories of gastrointestinal stromal tumors (GIST) is still unknown. The purpose of this study was to evaluate classical CT features, CT-perfusion and magnetic-resonance-diffusion-weighted-imaging (MR-DWI)-related parameters in predicting the metastatic risk of gastric GIST. Patients and methods: Sixty-two patients with histologically proven GIST who underwent CT perfusion and MR-DWI using multiple b-values were prospectively included.

Perforated Appendicitis and Bowel Incarceration within Morgagni Hernia: A Case Report.

Morgagni hernia (MH) is a result of abdominal organ protrusion through the congenital defect in the anterior retrosternal aspect of the diaphragm. The colon and omentum are the most commonly involved organs, followed by the small intestine, stomach and liver. Symptoms of MH may be absent, although the majority of patients will experience mild dyspnea or abdominal discomfort.

Aortoesophageal and aortobronchial fistula caused by Candida albicans after thoracic endovascular aortic repair.

Introduction: Endovascular stent-graft placement has emerged as a minimally invasive alternative to open surgery for the treatment of aortic aneurysms and dissections. There are few reports of stent graft infections and aortoenteric fistula after endovascular thoracic aortic aneurysm repair, and the first multicentric study (Italian survey) showed the incidence of about 2%.

Case Report: We presented a 69-year-old male patient admitted to our hospital 9 months after thoracic endovascular aortic repair, due to severe chest pain in the left hemithorax and arm refractory to analgesic therapy.

Does the computed tomography perfusion imaging improve the diagnostic accuracy in the response evaluation of esophageal carcinoma to the neoadjuvant chemoradiotherapy? Preliminary study.

Purpose: To estimate whether the computed tomography (CT) perfusion imaging could be useful to predict the pathological complete response (pCR) of esophageal cancer to the neoadjuvant chemoradiotherapy (NACRT).

Methods: Twenty-seven patients with the advanced squamous cell esophageal carcinoma, who were treated with concomitant CRT (CIS/5-FU/LV and 45-50 Gy total radiation dose), were re-evaluated using CT examination, which included the low-dose CT perfusion study. CT perfusion series were analysed using the deconvolution-based CT perfusion software (Perfusion 3.

Bloodless esophageal replacement in children with corrosive esophageal strictures--report of two cases.

Background: Esophageal replacement is major procedure with high risk for perioperative allogeneic blood transfusion (ABT), especially in pediatric patients due to nutritive deficiency, anemia, small body weight and blood volume. Autologous blood policy is particularly important in female children.

Methods: We present treatment strategy with the aim of avoiding ABT, that have been applied in two female pediatric patients with caustic stricture of thoracic esophagus.

Decompressive tube jejunogastrostomy after esophagectomy for carcinoma.

Background/aims: Gastric distension after esophagectomy and reconstruction with gastric conduit can promote both pulmonary complications and conduit ischaemia. The aim of this paper is to present a method of retrograde transjejunal decompression, with special emphasis on surgical technique and specific technique-related complications.

Methodology: In the period from January 2005 to December 2008 we prospectively evaluated 95 patients who underwent esophagectomy for carcinoma.

Pharyngolaryngoesophagectomy in a patient with an aberrant right subclavian artery: report of a case.

We report a case of carcinoma of the hypopharynx and cervical esophagus in a patient with an aberrant right subclavian artery. Barium esophagography, endoscopy, and computed tomography showed a resectable tumor in the hypopharynx and cervical esophagus, coexistent with an aberrant right subclavian artery. We performed pharyngolaryngoesophagectomy with bilateral neck dissection and gastric pull-up through cervical, right thoracic, and abdominal incisions.

Minimally invasive surgery in the treatment of gastric cancer.

Unlike benign pathology, progress of laparoscopy in performing cancer surgery has been slow because of fear of safety and oncological adequacy. However, the initial fear has been replaced by optimism as the results from a numerous studies have shown equivalent if not superior results to open surgery. Laparoscopic gastrectomy is safe and oncologic adequate, but time consuming and technically demanding procedure.

[The use of recombinant activated factor VII in the treatment of gastrointestinal bleeding following acetylsalicylic acid therapy in a surgical patient].

Introduction: Gastrointestinal bleeding is the most important complication associated with acetylsalicylic acid therapy. Patients with preexisting haemostatic disorders are at the higher risk and may experience life-threatening hemorrhagic syndrome. Platelet transfusions and desmopressin administration commonly successfully arrest bleeding.

Colon interposition for pharyngoesophageal postcorrosive strictures.

Background/aim: Aim of this paper is to report a 40 years experience in performing colon interposition for pharyngoesophageal caustic injury.

Methodology: In the period between 1965 and 2005, 83 colon interpositions were performed due to the pharyngeal and high esopahageal injuries. Patients were classified according to the uppermost level of stricture in 3 groups: supraglotic, hypopharyngeal and esophageal ostium.

Primary esophageal diffuse large B-cell lymphoma: report of a case.

Primary esophageal lymphoma is very rare, with fewer than 25 cases documented in the English-language literature. We report a case of primary diffuse large B-cell lymphoma of the esophagus in a 42-year-old woman. Barium esophagogram revealed almost complete esophageal obstruction at the level of the cervical esophagus, and flexible endoscopy showed a circumferential submucosal tumor covered with intact mucosa.

Intraoperative endoscopy in obstructive hypopharyngeal carcinoma.

Aim: To demonstrate the necessity of intraoperative endoscopy in the diagnosis of secondary primary tumors of the upper digestive tract in patients with obstructive hypopharyngeal carcinoma.

Methods: Thirty-one patients with hypopharyngeal squamous cell carcinoma had been operated, with radical intent, at our Institution in the period between 1978 and 2004. Due to obstructive tumor mass, in 7 (22.

[Prevalence and importance of nodal micrometastasis in patients with gastric adenocarcinoma].

Micrometastasis is a microscopic (less than 2 mm) deposit of malignant cells separated from the primary tumor. The incidence and importance of occult perigastric lymph node involvement were analyzed in 26 pN0 patients using the prospective method. The occult lymph node involvement was detected by immunohistochemical method using the anticytokeratin 8/18 antibody.