Annals of esophagus最新文献_第5页

Goals of endoscopic eradication therapy in Barrett’s esophagus: a narrative review Barrett食管内镜根除治疗的目标：叙述性综述

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

C. Frederiks, Sanne N. van Munster, B. Weusten

{"title":"Goals of endoscopic eradication therapy in Barrett’s esophagus: a narrative review","authors":"C. Frederiks, Sanne N. van Munster, B. Weusten","doi":"10.21037/AOE-2020-ETBE-04","DOIUrl":"https://doi.org/10.21037/AOE-2020-ETBE-04","url":null,"abstract":": Barrett’s esophagus is a premalignant condition, and endoscopic eradication therapy is indicated upon development of early neoplasia. Therapy consists of endoscopic resection for visible lesions, if present, followed by endoscopic ablation for remaining flat Barrett’s epithelium. Since Barrett’s esophagus with early neoplasia in itself is asymptomatic disease, the ultimate goal of endoscopic eradication therapy is to prevent progression to advanced cancer: a disease stage with limited treatment options and a poor prognosis. The preventive nature of endoscopic treatment may give rise to debate about the preferred endpoint to pursue. Establishment of a careful balance between the benefits of endoscopic eradication therapy against its risks, such as complications and other adverse events, may help to define the optimum endpoint for each individual patient. To date, various endpoints have been used in regular practice and different endpoints are used in clinical studies. The most important differences between these endpoints are whether all visible Barrett’s epithelium is eradicated or all dysplasia and cancer; and whether the endpoint is assessed on endoscopic examination only or with histologic confirmation. In this narrative review, we aim to evaluate these different endpoints of endoscopic eradication therapy with potential advantages and limitations, and present three clinical vignettes each with a different suggestion for an appropriate treatment endpoint. 10","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":"49538510","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

Esophageal duplication cyst recurrence: case report and literature review 食道重复囊肿复发1例并文献复习

Annals of esophagus Pub Date : 2021-01-01 DOI: 10.21037/aoe-2020-26

L. Pogliani, E. Zanfrini, D. Tabacco, E. Meacci, S. Margaritora, D. Nachira, V. Porziella

{"title":"Esophageal duplication cyst recurrence: case report and literature review","authors":"L. Pogliani, E. Zanfrini, D. Tabacco, E. Meacci, S. Margaritora, D. Nachira, V. Porziella","doi":"10.21037/aoe-2020-26","DOIUrl":"https://doi.org/10.21037/aoe-2020-26","url":null,"abstract":": Esophageal duplication cysts are rare congenital malformations, although most cases are diagnosed in childhood, in adult patients the disease is often symptomatic and requires invasive treatment. This kind of cyst can be found during endoscopy or Chest-X-Ray, but elective investigations consist in chest computed tomography (CT) scan or magnetic resonance imaging (MRI), if necessary, together with gastroscopy performed with endoscopic ultrasound (EUS). The therapeutic alternatives currently available are the surgical or endoscopic approach. In the past surgery was performed in thoracotomy, but several authors have reported cases treated with a minimally invasive approach with excellent short-term and long-term results. We present a case report of a 59-year-old Caucasian woman, affected by esophageal duplication cyst, and treated in 2003 with surgical fenestration in right triportal video-assisted thoracoscopic surgery (VATS) with complete regression of symptoms and resumption of normal nutrition. The cyst recurred in 2019 and the patient underwent further surgery with removal of the cyst in the right uniportal VATS. Postoperative course was regular, the symptoms disappeared, and no complications occurred. During follow-up, chest CT scan showed a complete pathological resolution without cystic recurrence. Currently, many authors agree that the minimally invasive surgical approach is the treatment of choice for esophageal duplication cysts. Our case report shows that VATS is efficient and safe even in treatment of surgical recurrences.","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":"45926500","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

Clinical applications of esophageal stents 食管支架的临床应用

Annals of esophagus Pub Date : 2021-01-01 DOI: 10.21037/aoe-21-29

Mallory K. Wilson, Shamus R. Carr

{"title":"Clinical applications of esophageal stents","authors":"Mallory K. Wilson, Shamus R. Carr","doi":"10.21037/aoe-21-29","DOIUrl":"https://doi.org/10.21037/aoe-21-29","url":null,"abstract":"Esophageal stents have been in surgical practice for over a century and continue to advance. Their use has led to changes in treatment paradigms and improved outcomes for a myriad of esophageal diseases. A variety of stents are used in the palliation of dysphagia in patients with malignant disease as well as part of a treatment plan in those with benign conditions. All stent placements begin with upper endoscopy in order to determine exact location of the pertinent pathology and use of a guidewire to set up for stent placement by the chosen technique. The type of stent chosen can vary based upon the etiology and presentation of each patient. In addition to stents that are commonly used today in management of patients, some of the newest developments in stent technology include 3D custom printed stents, biodegradable stents for benign strictures, or incorporating other therapeutic adjuncts to permit the slow-release of anti-cancer drugs. While complications during esophageal stent placement are rare, patients can experience bleeding or pain. These are generally self-limited. The most common complication is stent migration, which can be reduced with endoscopic fixation techniques. Much less common, but significantly more complex, is erosion through the esophagus. As surgical care continues to move towards less invasive approaches, endoscopic stent placement will continue to be a great option for numerous esophageal diseases. New opportunities for technological advancements are emerging that may further change current treatment algorithms for both malignant and benign pathologies. This may further give way to improved long-term outcomes or expansion of treatment options for patients.","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":"46029132","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

Indications for definitive chemoradiotherapy for oesophageal cancer 食管癌明确放化疗的适应症

Annals of esophagus Pub Date : 2021-01-01 DOI: 10.21037/AOE-2020-MTEC-09

S. Ng, T. Leong

{"title":"Indications for definitive chemoradiotherapy for oesophageal cancer","authors":"S. Ng, T. Leong","doi":"10.21037/AOE-2020-MTEC-09","DOIUrl":"https://doi.org/10.21037/AOE-2020-MTEC-09","url":null,"abstract":"Oesophageal cancer is the ninth most common cancer diagnosed, and seventh most common cause of cancer-related deaths worldwide. Despite significant advances in imaging, surgery, radiotherapy and systemic therapy over the past few decades, treatment outcomes in patients with localised oesophageal cancer remain suboptimal with a 5-year overall survival of less than 50%. Current treatment guidelines recommend surgery with/without pre-operative chemotherapy or chemoradiotherapy for patients with localised resectable disease. Hence, definitive radiotherapy (with or without chemotherapy) has predominantly been reserved for those who are deemed unsuitable for surgery. The role of radiotherapy in definitive management of oesophageal cancer has been recognised since the 1960s. The addition of concurrent chemotherapy has shown to improve treatment outcomes and has remained standard of care since the RTOG 85-01 and Intergroup 0123 trials. This review discusses the current literature on definitive radiotherapy with/without chemotherapy for localised oesophageal cancer, and evaluates current radiation modalities and technological developments in radiotherapy planning and delivery. We will provide an overview on the literature for definitive chemoradiotherapy in oesophageal cancer, the epidemiological and treatment response differences between squamous cell carcinoma and adenocarcinoma of the oesophagus, followed by a review of the current literature on different radiation treatment modalities (intensity modulated radiotherapy, brachytherapy and proton therapy) and the use of different imaging modalities for radiation treatment","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":"47456065","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

Long term care after successful endoscopic therapy in Barrett’s esophagus patients: a review of literature 巴雷特食管患者内镜治疗成功后的长期护理:文献综述

Annals of esophagus Pub Date : 2021-01-01 DOI: 10.21037/AOE-2020-ETBE-05

S. Srinivasan, M. Desai

{"title":"Long term care after successful endoscopic therapy in Barrett’s esophagus patients: a review of literature","authors":"S. Srinivasan, M. Desai","doi":"10.21037/AOE-2020-ETBE-05","DOIUrl":"https://doi.org/10.21037/AOE-2020-ETBE-05","url":null,"abstract":"Barrett’s esophagus (BE), a precursor to esophageal adenocarcinoma (EAC) has demonstrated a steep rise in incidence in the last few decades. Patients with high grade dysplasia and/or intramucosal carcinoma are indeed at a higher risk of progression to invasive cancer. Early recognition and endoscopic management could be curative. There have been significant strides in the endoscopic eradication therapy (EET) using resection and ablation techniques in the last 2 decades for management of BE with dysplasia. Once complete eradication is achieved after EET, it is important to follow-up these patients for complications and recurrence. While the importance of this long term-care is appreciated, there is a paucity of studies outlining long-term outcomes and post-therapy follow-up care data. Currently, the same aggressive principles used for original BE with neoplasia are being followed for subjects in remission. Precise definitions of follow up care and quality standards in maintaining durable efficacy are required. Novel techniques and biomarkers have been proposed to assist in the diagnosis and risk stratification but their role in this setting is still unclear. In this review, we present the literature and data on follow up and long-term care of BE patients after successful endoscopic therapy for BE associated dysplasia.","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":"49043460","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

Optimal management of locally advanced esophageal squamous cell carcinoma 局部晚期食管鳞状细胞癌的最佳治疗

Annals of esophagus Pub Date : 2021-01-01 DOI: 10.21037/aoe-21-59

J. Qin, X. Kang, Yin Li

引用次数: 0

Prophylactic eradication of non-dysplastic Barrett’s esophagus to prevent progression to esophageal adenocarcinoma—systematic review and meta-analysis 预防性根除非发育异常Barrett食管以预防进展为食管腺癌——系统综述和荟萃分析

Annals of esophagus Pub Date : 2021-01-01 DOI: 10.21037/aoe-21-43

Jasmijn Sijben, Y. Peters, P. Siersema

引用次数: 0

The upper esophageal sphincter: anatomy and physiology 食管上括约肌的解剖学和生理学

Annals of esophagus Pub Date : 2021-01-01 DOI: 10.21037/aoe-21-34

Apoorva T Ramaswamy, Per Martell, R. Azevedo, P. Belafsky

{"title":"The upper esophageal sphincter: anatomy and physiology","authors":"Apoorva T Ramaswamy, Per Martell, R. Azevedo, P. Belafsky","doi":"10.21037/aoe-21-34","DOIUrl":"https://doi.org/10.21037/aoe-21-34","url":null,"abstract":"The upper esophageal sphincter (UES), also known as the pharyngoesophageal segment (PES), is a 4-cm segment of the digestive tract that separates the esophagus from the pharynx and larynx. This narrative review represents an overview of the anatomy and physiology of this critical component of the airway protective mechanism. The structure is bounded anteriorly by the larynx, posterolaterally by the pharyngoesophageal muscles, superiorly by the pharynx and inferiorly by the esophagus. Guarding the entrance of the esophagus, the UES controls inflow and outflow through the region, preventing aerophagia in the anterograde direction as well as regurgitation in the retrograde. Although the cricopharyngeus muscle (CPM) is often considered synonymous with the UES, in reality it is but one component of the complicated anatomy. In fact, relaxation of the CPM is not the primary contributor to UES opening. During the act of swallow, the relaxation of the CPM, elevation of the larynx and propulsion of the food bolus by the pharynx coordinate to open the UES and facilitate deglutition. An understanding of the anatomy of the region in addition to the phases of UES opening facilitates more refined therapeutic interventions for patients with pharyngoesophageal swallow impairment and dysphagia.","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":"46214222","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

Current and future strategies in the treatment of esophageal cancer 癌症食管癌治疗的现状与未来策略

Annals of esophagus Pub Date : 2021-01-01 DOI: 10.21037/aoe-2020-51

S. Lagarde, B. Wijnhoven, F. Lordick

{"title":"Current and future strategies in the treatment of esophageal cancer","authors":"S. Lagarde, B. Wijnhoven, F. Lordick","doi":"10.21037/aoe-2020-51","DOIUrl":"https://doi.org/10.21037/aoe-2020-51","url":null,"abstract":"Esophageal cancer is an aggressive and often lethal disease with an increasing incidence worldwide. Originally, the only potentially curative treatment was esophagectomy. However, outcomes of locoregional advanced disease have improved substantially over the last decades by the incorporation of (neo)adjuvant treatment modalities (chemoand/or radiotherapy). Advances in radiotherapy techniques and modalities (e.g., proton therapy) facilitate ‘personalisation’ of high dose radiation delivery for patients who are not surgical candidates. As chemoradiation is very effective in a subset of patients leading to pathologically complete responses, the option of active surveillance instead of standard surgery is currently being investigated. Better patient selection, perioperative care as well as novel surgical techniques have improved the safety and efficacy of surgery. Minimally invasive esophagectomy is increasingly being used and although clear benefits have been described, there is a significant learning curve associated with this complex procedure. How can new surgical innovations be implemented safely now and in the future and what to do with patients who have been treated with definitive chemoradiation therapy? At some point in time, more than 50% of patients present with metastatic disease. Although survival remains dismal in the majority of these patients, there have been important developments in the treatment of dysphagia and a well selected subgroup of patients might be offered more aggressive multimodal therapy. Taken together, the treatment of esophageal cancer is rapidly evolving with novel multimodal developments. This special issue highlights the recent progress that has been made and hopefully this will translate into a more bright future for our patients.","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":"45694914","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

“Functional approach” to esophageal body diverticula 食道体憩室“功能入路”

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

M. Marchese, A. Capannolo, A. Giuliani, S. Valiyeva, F. Carlei, L. Lombardi

{"title":"“Functional approach” to esophageal body diverticula","authors":"M. Marchese, A. Capannolo, A. Giuliani, S. Valiyeva, F. Carlei, L. Lombardi","doi":"10.21037/AOE-2020-MEP-04","DOIUrl":"https://doi.org/10.21037/AOE-2020-MEP-04","url":null,"abstract":"Esophageal diverticula should be considered as epiphenomena of an esophageal motility disorder, thus a targeted approach should be taken into consideration when a treatment is indicated. Conventional surgical management consists in diverticulectomy or diverticulopexys, associated or not with a myotomy and/or fundoplication on the basis of the underlying motor disorder. A thorough endoscopic evaluation of the diverticulum, associated with a functional assessment of the esophageal motility is mandatory before the treatment. Surgical management of epiphrenic diverticula is often more challenging due to the long operation time and high postoperative complication and mortality rates, and reserved to referral centres. To date, despite the fact that diagnostic workup is now codified, there is not a solid consensus about the management of the diverticula, including the use of routine versus selective myotomy and whether or not a fundoplication should be included. Beyond its classical indications, recently the POEM technique has been applied for the performance of an endoscopic diverticulectomy by mean the submucosal myotomy of the diverticular septum. No literature data about the comparison between these different approaches are reported, so we reviewed literature data about the treatment modalities of diverticula of the esophageal body (mid-esophageal and epiphrenic), to highlight how to best address the choice.","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":"48097096","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