Background: Peroral endoscopic myotomy (POEM) has been widely performed as a standard treatment for achalasia; however, its efficacy and safety for treating distal esophageal segmental spasms induced by cancer metastasis remain unknown.
Case Summary: A 72-year-old male was referred to our hospital and complained of progressive dysphagia for two years. Endoscopy revealed a 2 cm long segment esophageal stenosis with intact mucosa and normal cardia. Computed tomography showed a right upper lung mass, and pathology of the right pleural effusion confirmed the diagnosis of right upper lung adenocarcinoma with multiple rib and mediastinal lymph node metastases and right malignant pleural effusion. Individualized POEM was performed first to alleviate dysphagia, and the final diagnosis was changed to esophageal muscle metastasis arising from lung adenocarcinoma. After treatment, the patient could eat soft solid food and received multiple rounds of pembrolizumab-combination chemotherapy. The patient's progression-free survival was approximately 16 months. Long stable disease was obtained during the 24-month follow-up.
Conclusion: The incidence of distal esophageal segmental spasms induced by muscular metastasis arising from lung adenocarcinoma is extremely low. Individualized POEM can effectively improve a patient's nutritional status before subsequent chemotherapy can be combined with immune checkpoint inhibitors.
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http://dx.doi.org/10.4240/wjgs.v16.i10.3321 | DOI Listing |
Cancer Lett
December 2024
Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China. Electronic address:
While metabolic reprogramming and remodeling of tumor microenvironment play important roles in the development of esophageal squamous cell carcinoma (ESCC), the mechanisms remain unclear. In this study, we found that pancreatic progenitor cell differentiation and proliferation factor (PPDPF) is upregulated in ESCC and its expression level is associated with lymph node metastasis. PPDPF was found to promote tumorigenesis, lymph node metastasis and distal metastasis of ESCC cells.
View Article and Find Full Text PDFPediatr Surg Int
December 2024
Division of Pediatric Surgery, Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Purpose: This study aims to evaluate the effectiveness of alternative autologous vessel grafts in creating a Meso-Rex bypass (MRB) compared to the distal splenorenal shunt (DSRS) in resolving symptoms of portal hypertension in children.
Methods: All children with EHPVO evaluated for surgery at Siriraj Hospital from January 2011 to December 2023 were reviewed. Alternative autologous vessel grafts were used in all cases where MRB was feasible.
Background And Aim: Spectrum of esophageal motility disorders may differ according to age, but studies on this are scanty, contradictory, and included small number of patients. Accordingly, we retrospectively analyzed data of a large sample of patients to study the spectrum of esophageal motility disorders in relation to age, and to evaluate the clinical profile and high-resolution manometry parameters and achalasia subtypes according to Chicago IV criteria.
Methods: Of 909 patients evaluated by high-resolution water perfusion or solid-state manometry during a 3-year period, data on 801 were finally analyzed.
Ulus Travma Acil Cerrahi Derg
January 2024
Department of General Surgery, Erciyes University Faculty of Medicine, Kayseri-Türkiye.
Background: Esophageal perforation is a serious medical condition where a hole or tear develops in the esophagus, the muscular tube that connects the throat to the stomach. Although rare, the condition is potentially life-threatening, as it can lead to infection and inflammation in surrounding tissues, including the mediastinum, pleura, and peritoneum.
Methods: Between 2014 and 2022, a retrospective study was conducted on cases of esophageal rupture treated at our institution.
Cureus
November 2024
Faculty of Life Sciences and Medicine, King's College London, London, GBR.
Introduction/aims The multichannel intraoesophageal impedance transit (MIIT) is a new clinical concept that is being introduced to measure the oesophageal transit during a 24-hour multichannel impedance-pH (MII-pH) study. Methods MIIT was tested in a case-control study between January 2020 and December 2023. A laboratory test was first conducted to determine the saline baseline impedance (SBI) using MII-pH catheters.
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