Annals of esophagus最新文献_第10页

A narrative review of the potential role of microaspiration and a dysregulated aerodigestive microbiome in lung disease 微吸入和失调的气消化微生物群在肺部疾病中的潜在作用的叙述性回顾

Annals of esophagus Pub Date : 2021-01-01 DOI: 10.21037/AOE-2020-EBMG-04

Abdullah Althuwaybi, A. Alamer, M. McDonnell, M. Brennan, R. Rutherford, M. Wilcox, P. Chater, J. Pearson, C. Ward

{"title":"A narrative review of the potential role of microaspiration and a dysregulated aerodigestive microbiome in lung disease","authors":"Abdullah Althuwaybi, A. Alamer, M. McDonnell, M. Brennan, R. Rutherford, M. Wilcox, P. Chater, J. Pearson, C. Ward","doi":"10.21037/AOE-2020-EBMG-04","DOIUrl":"https://doi.org/10.21037/AOE-2020-EBMG-04","url":null,"abstract":": When initiated the human microbiome project did not include the lungs and airways in its sampling sites, indicating an under appreciation of the role of the human lung microbiome in health and disease. This paradigm has recently changed through the use of culture independent methods to characterise the human lung microbiome. The original thinking, that the normal lung was essentially sterile, had previously been challenged by findings of microaspiration in normal volunteers and in patients with decreased levels of consciousness. The sterile lung was also questioned by findings of clinically occult infection markers in lung allograft recipients. What is arguably a “rediscovery” of the importance of the human lung microbiome may still underappreciate physiological and patho-physiological inter-relationships between organ systems, studied in separate research disciplines. In particular, microaspiration may be an important, direct mechanism through which the lung microbiome is modulated. As well as aspiration related to gastro-oesophageal reflux and microaspiration the authors feel that the importance of dysphagia in chronic lung disease, will be increasingly recognised in frailty related microbiome exchange between the oropharynx into the lung. This review therefore discusses interconnections in the human microbiome, with a focus on the potential for aerodigestive pathophysiology and microaspiration. Potential connections with human lung disease are discussed and contextualised within a developing literature. This review therefore highlights much needed new targets for translational intervention in lung pathophysiology and underlies the importance of a mixed disciplinary team approach for the future.","PeriodicalId":72217,"journal":{"name":"Annals of esophagus","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48285147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Endoscopic ultrasonography in esophageal carcinoma: a narrative review 食管癌的超声内镜检查综述

Annals of esophagus Pub Date : 2021-01-01 DOI: 10.21037/aoe-21-25

Zachary E. Daitch, S. Heller

{"title":"Endoscopic ultrasonography in esophageal carcinoma: a narrative review","authors":"Zachary E. Daitch, S. Heller","doi":"10.21037/aoe-21-25","DOIUrl":"https://doi.org/10.21037/aoe-21-25","url":null,"abstract":"Objective: The goal of this review is to summarize and discuss the role of endoscopic ultrasound (EUS) in the staging and diagnosis of esophageal carcinoma. Background: EUS has a well-established role in the diagnosis and staging of esophageal carcinoma. Technological advancements over the last three decades have increased the ability and utility of EUS; it is a mainstay in the workup of esophageal carcinoma. Methods: Literature review and summary of the available information relating to the use of EUS in practice, along with a review of its limitations in practice. Conclusions: The technology that underlies EUS has evolved over the last three decades. In particular, EUS plays a vital role in determining the extent of local extension of the tumor, which is defined using the T-staging system. Furthermore, it can accurately identify metastases to nearby lymph nodes and liver, and provides the capability of tissue sampling of metastatic disease with fine needle aspiration (FNA), thereby expanding its diagnostic power. As EUS has developed, it has surpassed other modalities for the purposes of both T and N staging of esophageal cancers as delineated by the American Joint Committee on Cancer/ Union for International Cancer Control (AJCC/UICC). EUS is a cornerstone in the multimodal approach to the diagnosis and staging of esophageal cancer which also includes upper endoscopy, cross-sectional imaging, positron emission tomography (PET) scanning, mediastinoscopy and laparoscopy. Limitations of EUS include operator dependence, understaging of the disease in obstructing tumors, difficulty differentiating between T2 and T3 disease, and reduced yield in patients following chemoradiation therapy.","PeriodicalId":72217,"journal":{"name":"Annals of esophagus","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43193777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Narrative review of worldwide data on outcomes of robotic esophagectomy 世界范围内机器人食管切除术结果数据的叙述性综述

Annals of esophagus Pub Date : 2021-01-01 DOI: 10.21037/aoe-21-56

E. Chan, M. V. Sanchez

引用次数: 0

A narrative review of the prevalence of gastroesophageal reflux disease (GERD) 胃食管反流病(GERD)患病率的述评

Annals of esophagus Pub Date : 2021-01-01 DOI: 10.21037/AOE-2020-EBMG-03

Katie H. A. Boulton, P. Dettmar

{"title":"A narrative review of the prevalence of gastroesophageal reflux disease (GERD)","authors":"Katie H. A. Boulton, P. Dettmar","doi":"10.21037/AOE-2020-EBMG-03","DOIUrl":"https://doi.org/10.21037/AOE-2020-EBMG-03","url":null,"abstract":": Over the years gastroesophageal reflux disease (GERD) has become a common disease worldwide affecting most countries and their populations. The history of the digestive system dates back to the 1400’s and reports on how the stomach had an acidic environment. The acidity and contents of the stomach refluxing up into the esophagus was later found in some cases to cause detrimental effects to one’s health. The earliest reports of reflux disease began in 1935 and was described as peptic esophagus. Many GERD patients complain of reflux, which is a back flow of gastric contents from the stomach into the esophagus, throat, lungs and airways. It is knowledge in the present day that GERD has a variety of symptoms such as regurgitation, coughing and heartburn greatly impacting on an individual’s quality of life (QOL). An increased awareness of the pathology of GERD has allowed for a number of treatments and medicines to be developed, clinically evaluated and used worldwide. To gain an insight into how prevalent GERD is globally, this review will aim to report on its prevalence in different countries and regions of the world and report on the relevant causes associated with GERD. The influence of age, obesity, pregnancy, stress, smoking and alcohol on GERD will be reviewed along with the role of diet and how certain foods and drinks can trigger reflux events. Future research of the prevalence of GERD will help to educate people on lifestyle choices to manage GERD symptoms which in turn will improve quality of life and prevent GERD and GERD related diseases. GERD in GERD","PeriodicalId":72217,"journal":{"name":"Annals of esophagus","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48747779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 11

Endoscopic management of complications—endovacuum for management of anastomotic leakages: a narrative review 并发症的内镜处理-吻合口瘘的内镜处理:叙述性回顾

Annals of esophagus Pub Date : 2021-01-01 DOI: 10.21037/AOE-21-16

C. Mann, F. Berlth, E. Tagkalos, E. Hadzijusufoviç, H. Lang, P. Grimminger

{"title":"Endoscopic management of complications—endovacuum for management of anastomotic leakages: a narrative review","authors":"C. Mann, F. Berlth, E. Tagkalos, E. Hadzijusufoviç, H. Lang, P. Grimminger","doi":"10.21037/AOE-21-16","DOIUrl":"https://doi.org/10.21037/AOE-21-16","url":null,"abstract":": Anastomotic leakages after esophagectomy are common, yet threatening complications. Possible leakage therapy ranges from reoperation to interventional treatments like stent placement or endoscopic vacuum therapy (EVAC) supported by optimized conservative therapy, ideally at an intensive care unit. Since reoperation is concomitant with high mortality, conservative and interventional therapies are applied on a frequent basis nowadays. Apart from the well-established endoscopic placement of a self-expanding-metal stent (SEMS), the EVAC has been successfully implemented in many centers in recent years. Using the same principles as subcutaneous vacuum therapy, it offers many advantages such as simultaneous drainage therapy and faster healing process. The healing process is supported by controlling the infection of the wound, promoting macro- and microdeformation of the adjacent tissue, and improvement of perfusion. Still, clear evidence about superiority of one interventional therapy strategy—either SEMS or EVAC—is lacking. This article describes the principle and the procedure of EVAC for anastomotic leakages. Current literature regarding efficiency, safety, and possible costs in comparison to SEMS therapy is reviewed. Considering the advantages EVAC therapy is offering, its value for anastomotic leakage therapy is clear. However, to reach standardized clinical application, additional research to improve the applicability and economic efficiency should be conducted.","PeriodicalId":72217,"journal":{"name":"Annals of esophagus","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44791183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Salvage surgery after definitive chemoradiotherapy for esophageal cancer 食管癌放化疗后的抢救手术

Annals of esophagus Pub Date : 2021-01-01 DOI: 10.21037/aoe-2020-10

Yaseen Al Lawati, L. Ferri

{"title":"Salvage surgery after definitive chemoradiotherapy for esophageal cancer","authors":"Yaseen Al Lawati, L. Ferri","doi":"10.21037/aoe-2020-10","DOIUrl":"https://doi.org/10.21037/aoe-2020-10","url":null,"abstract":": Salvage esophageal resection after chemoradiation is an increasingly recognized clinical challenge, especially in the context of esophageal squamous cell carcinoma. Despite that, there have been varying definitions of salvage in the literature, leading to difficulties in interpreting data. This is further complicated by the limitations in assessing clinical complete response after chemoradiation. At the same time, salvage esophagectomy has classically been approached with reservation because of the associated morbidity and mortality, especially that definitive chemoradiation is sometimes the preferred choice of treatment for borderline-operable and borderline-resectable patients. While some reports have shown good survival outcomes, others have shown the opposite. Yet, the morbidity rate remains relatively high. From a surgical point of view, borderline-operable patients can be further optimized with specialized prehabilitation programs, which have been demonstrated to be useful in gastroesophageal cancers. Intraoperatively, there are important technical modifications that need to be taken into consideration. A special consideration should also be given to patients with limited airway involvement. In this review, we explore the different definitions of salvage and discuss clinical complete response after chemoradiation. We also discuss the postoperative and survival outcomes of salvage esophagectomy. A special focus is given to preoperative optimization and intraoperative technical aspects, including airway resection. Finally, the ongoing clinical trials looking into this subject are discussed.","PeriodicalId":72217,"journal":{"name":"Annals of esophagus","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42528709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Relay therapy with endovac and endoscopic stents for anastomotic leaks after minimally invasive esophagectomy 微创食管切除术后吻合口瘘的腔内支架和内镜支架接力治疗

Annals of esophagus Pub Date : 2021-01-01 DOI: 10.21037/aoe-21-44

Matias Turchi, Federico Llanos, Mauricio Ramirez, Franco Badaloni, F. Nachman, A. Nieponice

引用次数: 0

Role of surgery in the management of synchronous metastatic esophageal cancer 手术在同步转移性食管癌治疗中的作用

Annals of esophagus Pub Date : 2021-01-01 DOI: 10.21037/AOE-2020-MTEC-07

M. Chevallay, M. Jung, Charles-Henri Wassmer, S. Mönig

{"title":"Role of surgery in the management of synchronous metastatic esophageal cancer","authors":"M. Chevallay, M. Jung, Charles-Henri Wassmer, S. Mönig","doi":"10.21037/AOE-2020-MTEC-07","DOIUrl":"https://doi.org/10.21037/AOE-2020-MTEC-07","url":null,"abstract":"Metastatic cancer of the esophagus has a poor prognosis. For many years, surgery had no place in their management and chemo(radio)therapy was the only therapy. In patients with metastatic colon and breast cancer, surgical resection of the metastases was shown to improve long term outcomes. For the upper digestive tract, metastasectomy was first described in gastric cancer. This led to the introduction of surgery for metastatic esophageal cancer. With the progress in chemo(radio)therapy regimens and surgical techniques, complete resection of all disease has become possible particularly in patients with oligometastases. To achieve a survival advantage, obtaining a negative resection margin of the metastases is essential. Preoperative workup should therefore focus on the possibility of a complete resection. Patient selection is crucial and should be discussed in multidisciplinary tumor boards. Prognostic scores exist and can be used to predict the survival of these patients. In this review, studies on the surgical management of synchronous metastases of esophageal cancer are discussed. The results of ongoing randomized trials will help clarify if there is truly a place for surgery for synchronous metastatic disease.","PeriodicalId":72217,"journal":{"name":"Annals of esophagus","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41534506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Laparoscopic Nissen fundoplication for gastroesophageal reflux disease in situs inversus totalis: a “self-solving puzzle”—a case report 腹腔镜Nissen胃底折叠术治疗全反位胃食管反流病：一个“自我解决的难题”——一例报告

Annals of esophagus Pub Date : 2021-01-01 DOI: 10.21037/AOE-20-63

L. Antozzi, P. Renda

{"title":"Laparoscopic Nissen fundoplication for gastroesophageal reflux disease in situs inversus totalis: a “self-solving puzzle”—a case report","authors":"L. Antozzi, P. Renda","doi":"10.21037/AOE-20-63","DOIUrl":"https://doi.org/10.21037/AOE-20-63","url":null,"abstract":": We report a laparoscopic Nissen fundoplication for gastroesophageal reflux disease (GERD) in a patient with situs inversus totalis (SIT), focusing on the surgical anatomical challenge. GERD with SIT is a very rare condition, and because of its extremely low prevalence, it presents a once-in-a-lifetime challenge for the gastroesophageal surgeon. A laparoscopic approach with minimum modifications enabled us to perform surgery as in patients with normal anatomy. In this article we describe in detail how we adapted the surgical technique to the anatomic alteration, so it can be reproduced elsewhere. We share our experience and the challenges we encountered, with the objective to give insight to a surgeon confronting a similar scenario. This is the case of a 65-year-old female, with hiatal hernia, GERD symptoms, and chronic obstructive pulmonary disease (COPD) exacerbations, which required continuous treatment adjustment. After proper evaluation, we performed a hiatoplasty and laparoscopic floppy Nissen, with only surgical ports placement modifications. We found few difficulties during surgery and a swift and ergonomic dissection for the right-handed surgeon. The patient was discharged on the second day after tolerating oral feeds. After 6 months, the patient remains asymptomatic without further COPD exacerbations. To the best of our knowledge, we present which is possibly the first reported case of a laparoscopic Nissen fundoplication in SIT in Latin America.","PeriodicalId":72217,"journal":{"name":"Annals of esophagus","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49536804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Multimodal therapy for esophageal squamous cell carcinoma according to TNM staging in Japan—a narrative review of clinical trials conducted by Japan Clinical Oncology Group 日本食管鳞状细胞癌TNM分期的多模式治疗——日本临床肿瘤组临床试验的叙述性回顾

Annals of esophagus Pub Date : 2021-01-01 DOI: 10.21037/aoe-21-22

Kohei Kanamori, K. Koyanagi, S. Ozawa, Miho Yamamoto, Y. Ninomiya, K. Yatabe, T. Higuchi, K. Tajima

引用次数: 0