100 esophagectomies were performed at the Waid Hospital in Zürich between 1981-1988. 55 patients underwent blunt esophagectomy without thoracotomy, 34 abdomino-thoracic resection with intrathoracic anastomosis, and 11 abdomino-thoracic resection with lymphadenectomy and cervical anastomosis. In 80% the tumor had spread through the esophageal wall or there were already regional lymph node metastases. Adenocarcinoma was found in 2/3 of the patients and epidermoid carcinoma in 1/3. 30-day mortality was 5%. The actuarial 5-year survival rate is 14%. Average hospital stay was 30 days. Blunt esophagectomy was mainly performed in older patients with tumor localization in the lower third. Abdomino-thoracic resection with cervical anastomosis was preferred for younger patients with tumor localization in the middle third. Surgical resection is the only curative therapy in esophageal cancer, but due to the often advanced tumor stage it is often only of palliative character.
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Chirurgie (Heidelb)
January 2025
Surgery, Wilhelmsburger Krankenhaus Groß-Sand, Groß-Sand 3, 21107, Hamburg, Germany.
Introduction: Early postoperative reflux (PR) can compromise anastomotic healing after Ivor Lewis esophagectomy (ILE) and poses a risk for aspiration. Anastomotic insufficiency is the most threatening surgical complication. We present the protective method of pre-emptive active reflux drainage (PARD) with simultaneous enteral feeding.
View Article and Find Full Text PDFHernia
February 2022
Department of General, Visceral, Thoracic, Transplant and Pediatric Surgery, University Hospital of Giessen, Rudolf-Buchheim-Strasse 7, 35392, Giessen, Germany.
Purpose: Trans-hiatal herniation after esophago-gastric surgery is a potentially severe complication due to the risk of bowel incarceration and cardiac or respiratory complaints. However, measures for prevention and treatment options are based on a single surgeon´s experiences and small case series in the literature.
Methods: Retrospective single-center analysis on patients who underwent surgical repair of trans-hiatal hernia following gastrectomy or esophagectomy from 01/2003 to 07/2020 regarding clinical symptoms, hernia characteristics, pre-operative imaging, hernia repair technique and perioperative outcome.
BMC Gastroenterol
February 2021
Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany.
Background: Anastomotic leakage (AL) in the upper gastrointestinal (GI) tract is associated with high morbidity and mortality rates. Especially intrathoracic anastomotic leakage leads to life-threatening complications. Endoscopic vacuum therapy (EVT) for anastomotic leakage after transthoracic esophageal resection represents a novel concept.
View Article and Find Full Text PDFUnlabelled: Esophageal surgery has been recognized as very challenging for surgeons and risky for patients. Thoracoscopic approach have proved its benefit in esophageal surgery but has some drawbacks as tremor and limited degrees of freedom, contra-intuitive movements and fulcrum effect of the surgical tools. Robotic technology has been developed with the intent to overcome these limitations of the standard laparoscopy or thoracoscopy.
View Article and Find Full Text PDFPol Przegl Chir
March 2011
Department of General, Abdominal and Vascular Surgery, Municipal Hospital, Halberstadt, Germany.
Unlabelled: Gunshot wounds are rare events in European countries, but stab and impalement injuries occur more frequently and are often spectacular. The aim of the study was to describe several types of penetrating abdomino-thoracic injuries as well as the appropriate surgical interventions, including complex wound management.
Material And Methods: The representative case series includes four patients with abdomino-thoracic penetrating trauma (two impalements and two stabbings), who were treated in a surgical university hospital (tertiary) centre during a 12-month period.
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