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].
- Esophageal surgical resection via colonic interposition between cervical esophagus and duodenum or stomach [2]
- Patients with undilatable strictures, are candidates for transhiatal esophageal resection with replacement by either stomach, colon or jejunum. Laparoscopic esophagectomy is now routinely performed in a few centers, however, evidence of superior outcomes as compared to open surgery is still pending.[3]
Indications for surgery[4]
- 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.
- ↑ 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.
- ↑ Holzheimer, R (2001). Surgical treatment : evidence-based and problem-oriented. München New York: Zuckschwerdt. ISBN 3-88603-714-2.