Esophageal stricture surgery: Difference between revisions
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==Overview== | ==Overview== | ||
The mainstay of treatment for [[esophageal stricture]] is dilation. Proton pump inhibitors or H2 antagonists are recommended among all patients who develop esophageal stricture due to gastroesophageal reflux disease. Self-expandable plastic or metal [[Stent|stents]] placement is indicated for patients with refractory esophageal stricture. Surgery is usually reserved for patients with either inability to dilate the stricture, frequent recurrence of [[dysphagia]], extraesophageal manifestations and long term [[side effects]] of medical therapy | The mainstay of treatment for [[esophageal stricture]] is [[dilation]]. [[Proton pump inhibitor|Proton pump inhibitors]] or [[Histamine-2 receptor blocker|H2 antagonists]] are recommended among all patients who develop [[esophageal]] [[stricture]] due to [[gastroesophageal reflux disease]]. Self-expandable plastic or metal [[Stent|stents]] placement is indicated for patients with refractory [[esophageal]] [[stricture]]. [[Surgery]] is usually reserved for patients with either inability to dilate the stricture, frequent recurrence of [[dysphagia]], extraesophageal manifestations and long term [[side effects]] of medical therapy | ||
==Surgery== | ==Surgery== | ||
Surgery is not the first-line treatment option for patients with esophageal stricture because it can lead to serious morbidity and mortality. <ref name="pmid21346853">{{cite journal |vauthors=Baron TH |title=Management of benign esophageal strictures |journal=Gastroenterol Hepatol (N Y) |volume=7 |issue=1 |pages=46–9 |year=2011 |pmid=21346853 |pmc=3038317 |doi= |url=}}</ref> | [[Surgery]] is not the [[first-line treatment]] option for patients with [[esophageal]] [[stricture]] because it can lead to serious morbidity and mortality. <ref name="pmid21346853">{{cite journal |vauthors=Baron TH |title=Management of benign esophageal strictures |journal=Gastroenterol Hepatol (N Y) |volume=7 |issue=1 |pages=46–9 |year=2011 |pmid=21346853 |pmc=3038317 |doi= |url=}}</ref> | ||
Surgery is usually reserved for patients with either:<ref name=":0">{{cite book | last = Holzheimer | first = R | title = Surgical treatment : evidence-based and problem-oriented | publisher = Zuckschwerdt | location = München New York | year = 2001 | isbn = 3-88603-714-2 }}</ref> | [[Surgery]] is usually reserved for patients with either:<ref name=":0">{{cite book | last = Holzheimer | first = R | title = Surgical treatment : evidence-based and problem-oriented | publisher = Zuckschwerdt | location = München New York | year = 2001 | isbn = 3-88603-714-2 }}</ref> | ||
* Inability to [[dilate]] the stricture | * Inability to [[dilate]] the [[stricture]] | ||
* Frequent recurrence of dysphagia | * Frequent recurrence of [[dysphagia]] | ||
* [[Esophagitis]] refractory to medical therapy | * [[Esophagitis]] refractory to medical therapy | ||
* Extraesophageal manifestations such as [[aspiration pneumonia]] | * Extraesophageal manifestations such as [[aspiration pneumonia]] | ||
* Long term side effects of medical therapy in young patients. | * Long term [[side effects]] of medical therapy in young patients. | ||
Some methods of surgery are included: | Some methods of [[surgery]] are included: | ||
* Laparoscopic esophagectomy <ref name=":0" /> | * [[Laparoscopic]] [[esophagectomy]]<ref name=":0" /> | ||
* Pharyngoesophageal puncture in severe upper esophageal [[stenosis]] after [[radiation therapy]] for [[laryngeal]] and [[Hypopharyngeal cancer|hypopharyngeal cancers]] | * Pharyngoesophageal puncture in severe upper [[esophageal]] [[stenosis]] after [[radiation therapy]] for [[laryngeal]] and [[Hypopharyngeal cancer|hypopharyngeal cancers]]<ref name="pmid19517185">{{cite journal |vauthors=Tang SJ, Singh S, Truelson JM |title=Endotherapy for severe and complete pharyngo-esophageal post-radiation stenosis using wires, balloons and pharyngo-esophageal puncture (PEP) (with videos) |journal=Surg Endosc |volume=24 |issue=1 |pages=210–4 |year=2010 |pmid=19517185 |doi=10.1007/s00464-009-0535-y |url=}}</ref> | ||
*Esophageal surgical [[resection]] via colonic interposition between cervical [[esophagus]] and [[duodenum]] or [[stomach]] especially after caustic injury <ref name="pmid1483661">{{cite journal |vauthors=Csendes A, Braghetto I |title=Surgical management of esophageal strictures |journal=Hepatogastroenterology |volume=39 |issue=6 |pages=502–10 |year=1992 |pmid=1483661 |doi= |url=}}</ref><ref name="pmid15334683">{{cite journal |vauthors=Han Y, Cheng QS, Li XF, Wang XP |title=Surgical management of esophageal strictures after caustic burns: a 30 years of experience |journal=World J. Gastroenterol. |volume=10 |issue=19 |pages=2846–9 |year=2004 |pmid=15334683 |pmc=4572115 |doi= |url=}}</ref> | *[[Esophageal]] surgical [[resection]] via colonic interposition between [[cervical]] [[esophagus]] and [[duodenum]] or [[stomach]] especially after [[caustic]] injury<ref name="pmid1483661">{{cite journal |vauthors=Csendes A, Braghetto I |title=Surgical management of esophageal strictures |journal=Hepatogastroenterology |volume=39 |issue=6 |pages=502–10 |year=1992 |pmid=1483661 |doi= |url=}}</ref><ref name="pmid15334683">{{cite journal |vauthors=Han Y, Cheng QS, Li XF, Wang XP |title=Surgical management of esophageal strictures after caustic burns: a 30 years of experience |journal=World J. Gastroenterol. |volume=10 |issue=19 |pages=2846–9 |year=2004 |pmid=15334683 |pmc=4572115 |doi= |url=}}</ref> | ||
==References== | ==References== | ||
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[[Category:Gastroenterology]] | [[Category:Gastroenterology]] | ||
[[Category:Medicine]] | [[Category:Medicine]] | ||
[[Category:Up-To-Date]] | [[Category:Up-To-Date]] | ||
[[Category: | [[Category:Surgery]] | ||
Latest revision as of 21:41, 29 July 2020
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Esophageal stricture Microchapters |
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Diagnosis |
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Treatment |
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Surgery |
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Case Studies |
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Esophageal stricture surgery On the Web |
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American Roentgen Ray Society Images of Esophageal stricture surgery |
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Risk calculators and risk factors for Esophageal stricture surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahda Alihashemi M.D. [2]
Overview
The mainstay of treatment for esophageal stricture is dilation. Proton pump inhibitors or H2 antagonists are recommended among all patients who develop esophageal stricture due to gastroesophageal reflux disease. Self-expandable plastic or metal stents placement is indicated for patients with refractory esophageal stricture. Surgery is usually reserved for patients with either inability to dilate the stricture, frequent recurrence of dysphagia, extraesophageal manifestations and long term side effects of medical therapy
Surgery
Surgery is not the first-line treatment option for patients with esophageal stricture because it can lead to serious morbidity and mortality. [1]
Surgery is usually reserved for patients with either:[2]
- Inability to dilate the stricture
- Frequent recurrence of dysphagia
- Esophagitis refractory to medical therapy
- Extraesophageal manifestations such as aspiration pneumonia
- Long term side effects of medical therapy in young patients.
Some methods of surgery are included:
- Pharyngoesophageal puncture in severe upper esophageal stenosis after radiation therapy for laryngeal and hypopharyngeal cancers[3]
- Esophageal surgical resection via colonic interposition between cervical esophagus and duodenum or stomach especially after caustic injury[4][5]
References
- ↑ Baron TH (2011). "Management of benign esophageal strictures". Gastroenterol Hepatol (N Y). 7 (1): 46–9. PMC 3038317. PMID 21346853.
- ↑ 2.0 2.1 Holzheimer, R (2001). Surgical treatment : evidence-based and problem-oriented. München New York: Zuckschwerdt. ISBN 3-88603-714-2.
- ↑ Tang SJ, Singh S, Truelson JM (2010). "Endotherapy for severe and complete pharyngo-esophageal post-radiation stenosis using wires, balloons and pharyngo-esophageal puncture (PEP) (with videos)". Surg Endosc. 24 (1): 210–4. doi:10.1007/s00464-009-0535-y. PMID 19517185.
- ↑ Csendes A, Braghetto I (1992). "Surgical management of esophageal strictures". Hepatogastroenterology. 39 (6): 502–10. PMID 1483661.
- ↑ Han Y, Cheng QS, Li XF, Wang XP (2004). "Surgical management of esophageal strictures after caustic burns: a 30 years of experience". World J. Gastroenterol. 10 (19): 2846–9. PMC 4572115. PMID 15334683.