Esophageal stricture surgery
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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
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- Pharyngoesophageal puncture in severe upper esophageal stenosis after radiation therapy for laryngeal and hypopharyngeal cancers [1]
- Brachytherapy is recommended among patients with malignant esophageal stricture with a life expectancy more than three months.[2]
- Stent placement for malignant esophageal stricture as a palliative therapy with expected survival time less than three months[2][3]
- Feeding tube and gastrostomy for patients that are not good candidate for surgery [4]
- Esophageal surgical resection via colonic interposition between cervical esophagus and duodenum or stomach [5]
Indications for surgery[6]
- 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.
References
- ↑ 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.
- ↑ 2.0 2.1 Kujawski K, Stasiak M, Rysz J (2012). "The evaluation of esophageal stenting complications in palliative treatment of dysphagia related to esophageal cancer". Med. Sci. Monit. 18 (5): CR323–9. PMC 3560635. PMID 22534713.
- ↑ Siersema PD (2008). "Treatment options for esophageal strictures". Nat Clin Pract Gastroenterol Hepatol. 5 (3): 142–52. doi:10.1038/ncpgasthep1053. PMID 18250638.
- ↑ Yang CW, Lin HH, Hsieh TY, Chang WK (2015). "Palliative enteral feeding for patients with malignant esophageal obstruction: a retrospective study". BMC Palliat Care. 14: 58. doi:10.1186/s12904-015-0056-5. PMC 4635529. PMID 26542798.
- ↑ Csendes A, Braghetto I (1992). "Surgical management of esophageal strictures". Hepatogastroenterology. 39 (6): 502–10. PMID 1483661.
- ↑ Holzheimer, R (2001). Surgical treatment : evidence-based and problem-oriented. München New York: Zuckschwerdt. ISBN 3-88603-714-2.