The main cause of lethal outcomes after operations on the oesophagus and cardia remains failure of esophageal anastomosis. The lack of substantial positive changes in prophylaxis and especially in treatment of this complication is explained by etiological approach to this problem. Pathogenesis of the failure is determined by the only trigger--penetration of infection into the tissues of anastomotic area. The authors have developed and introduced into practice the method and the device to influence the basic link of the pathogenesis. The application of the method of permanent irrigation and sealing of the esophageal anastomosis line in treatment of 917 patients made it possible to cut down lethal outcomes from insufficiency of esophageal anastomosis to 0.1%.
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JTCVS Open
December 2024
Department of Thoracic and Endocrine Surgery, Centre Jean Perrin, Clermont-Ferrand, France.
Objective: The study objective was to assess the efficacity of different surgical strategies for atrioesophageal fistula after catheter ablation of atrial fibrillation.
Methods: Between January 2010 and April 2023, all patients with a diagnosis of atrioesophageal fistula or pericardo-esophageal fistula after catheter ablation of atrial fibrillation were analyzed retrospectively from the French database EPITHOR. Patients without surgical management were excluded.
Several reconstruction methods are used in proximal gastrectomy. Esophagogastrostomy is the simplest and most physiological. The challenge in esophagogastrostomy is preventing reflux esophagitis.
View Article and Find Full Text PDFGastroenterol Hepatol
January 2025
Servicio de Hepatología, Hospital Clínic, Institut de Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universidad de Barcelona, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, España. Electronic address:
Portal hypertension is a hemodynamic abnormality that complicates the course of cirrhosis, as well as other diseases that affect the portal venous circulation. The development of portal hypertension compromises prognosis, especially when it rises above a certain threshold known as clinically significant portal hypertension (CSPH). In the consensus conference on Portal Hypertension promoted by the Spanish Association for the Study of the Liver and the Hepatic and Digestive diseases area of the Biomedical Research Networking Center (CIBERehd), different aspects of the diagnosis and treatment of portal hypertension caused by cirrhosis or other diseases were discussed.
View Article and Find Full Text PDFIn Vivo
December 2024
Department of Surgery, Clinical Center, Medical School, University of Pécs, Pécs, Hungary.
Background/aim: Enhanced recovery after surgery (ERAS) protocol is adopted in clinical practice worldwide, but a lack of evidence for measurable benefits after upper gastrointestinal (GI) surgeries can be detected especially regarding early oral feeding.
Patients And Methods: A propensity score-matching study was conducted at the Department of Surgery of the University of Pécs between January 2020 and December 2023. The study included patients who underwent upper GI cancer surgery and were treated according to an early oral feeding protocol (EOF).
Obes Surg
December 2024
Department of Upper Gastrointestinal and Bariatric Surgery, University Hospitals Sussex (St Richard's Hospital), Chichester, UK.
Introduction: Roux-en-Y gastric bypass (RYGB) reversal might be necessary to alleviate refractory surgical or nutritional complications, such as postprandial hypoglycemia, malnutrition, marginal ulceration, malabsorption, chronic diarrhea, nausea and vomiting, gastro-esophageal reflux disease, chronic pain, or excessive weight loss. The surgical technique of RYGB reversal is not standardized; potential strategies include the following: (1) gastro-gastrostomy: hand-sewn technique, linear stapler, circular stapler; (2) handling of the Roux limb: reconnection or resection (if remaining intestinal length ≥ 4 m).
Case Presentation: We demonstrate the surgical technique of a laparoscopic reversal of RYGB with hand-sewn gastro-gastrostomy and resection of the alimentary limb with the aim of improving the patient's quality of life.
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