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Dysphagia following treatment for esophageal cancer: rehabilitation strategies. 食管癌治疗后的吞咽困难:康复策略。
Rays Pub Date : 2006-01-01
Angela Romanelli, Anna Bozzone, Giovanni Magrone, Simona Di Lello, Biancalisa Pascarella, Silvia Sterzi
{"title":"Dysphagia following treatment for esophageal cancer: rehabilitation strategies.","authors":"Angela Romanelli,&nbsp;Anna Bozzone,&nbsp;Giovanni Magrone,&nbsp;Simona Di Lello,&nbsp;Biancalisa Pascarella,&nbsp;Silvia Sterzi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Dysphagia represents one of the first possible presenting symptoms of tumors of the esophagus and is one of the main consequences of surgical intervention performed on these tumors. Its treatment is based on accurate evaluation of the residual functional deficit (as well as of the possible pre-existing deglutition deficit) and on implementing both general and specific rehabilitation treatment. These interventions should be carried out by a team of professionals who work together in an integrated and coordinated approach to the global caregiving of patients undergoing esophagectomy, taking into consideration the diverse physical and psychological problems associated with tumor pathology and its treatment modality.</p>","PeriodicalId":77342,"journal":{"name":"Rays","volume":"31 1","pages":"53-5"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26273104","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
Positron emission tomography in the staging of esophageal cancer. 正电子发射断层扫描在食管癌分期中的应用。
Rays Pub Date : 2006-01-01
Lucia Leccisotti
{"title":"Positron emission tomography in the staging of esophageal cancer.","authors":"Lucia Leccisotti","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Accurate staging of patients with esophageal cancer (EC) is essential for selection of appropriate treatment and to predict prognosis. In recent years, positron emission tomography using the positron emitting glucose analogue 18F- fluorodeoxyglucose (FDG-PET) has emerged as a particularly useful adjunct to anatomical imaging modalities as computed tomography (CT) and endoscopic ultrasonography (EUS). In the initial staging of EC the additional value of FDG-PET is its ability to identify distant metastases (stage IV disease), excluding patients from unnecessary surgery. The combination of FDG-PET and endoscopic ultrasonography with fine-needle aspiration (EUS-FNA) has been suggested as the most effective strategy for preoperative EC staging.</p>","PeriodicalId":77342,"journal":{"name":"Rays","volume":"31 1","pages":"9-12"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26273168","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
Neoadjuvant therapy for esophageal cancer: surgical considerations. 食管癌的新辅助治疗:手术方面的考虑。
Rays Pub Date : 2006-01-01
Alessio Piraino, Maria Letizia Vita, Adele Tessitore, Giacomo Cusumano, Maria Teresa Congedo, Stefano Margaritora, Venanzio Porziella, Elisa Meacci, Alfredo Cesario, Pierluigi Granone
{"title":"Neoadjuvant therapy for esophageal cancer: surgical considerations.","authors":"Alessio Piraino,&nbsp;Maria Letizia Vita,&nbsp;Adele Tessitore,&nbsp;Giacomo Cusumano,&nbsp;Maria Teresa Congedo,&nbsp;Stefano Margaritora,&nbsp;Venanzio Porziella,&nbsp;Elisa Meacci,&nbsp;Alfredo Cesario,&nbsp;Pierluigi Granone","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Esophageal carcinoma is often diagnosed at an advanced, non resectable stage. Only early stages show a better prognosis. Surgical treatment represents the gold standard. The various surgical techniques do not seem to affect survival. Based on the severity of esophageal cancer and on poor outcome achievable with surgery alone, multimodality treatments are the most suitable. The possible negative impact on the complication rate after neoadjuvant therapy is still debated. Most randomized trials have not demonstrated as yet an improvement in prognosis in patients undergoing a three-modality treatment. However, patients with complete pathologic response after surgical resection were shown to have a better prognosis. In conclusion, additional randomized trials are required, aimed at evaluating all technical and therapeutic variables which affect prognosis.</p>","PeriodicalId":77342,"journal":{"name":"Rays","volume":"31 1","pages":"37-45"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26273103","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
Sems (self expanding metal stents) in a patient with esophagogastric cancer and esophagorespiratory fistula (ERF). 食管胃癌合并食管呼吸瘘(ERF)患者的自膨胀金属支架。
Rays Pub Date : 2006-01-01
Marilena Montesano, Pierfilippo Crucitti, Monica Pandolfi, Annie Zanca, Armando Gabbrielli, Roberto Coppola
{"title":"Sems (self expanding metal stents) in a patient with esophagogastric cancer and esophagorespiratory fistula (ERF).","authors":"Marilena Montesano,&nbsp;Pierfilippo Crucitti,&nbsp;Monica Pandolfi,&nbsp;Annie Zanca,&nbsp;Armando Gabbrielli,&nbsp;Roberto Coppola","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Esophagorespiratory fistulas, especially in the upper third of the esophagus, are a complication of malignant esophageal tumors, whose management is difficult and prognosis is poor. Treatment is palliative and involves restoration of the ability to ingest food and prevention of aspiration by insertion of esophageal or tracheobronchial stents. In selected patients the insertion of a single stent may be insufficient for pallation therefore the placement of parallel stents may be indicated in patients with symptoms caused by malignant esophagorespiratory fistula. A case of esophagorespiratory fistula managed with insertion of parallel stents is presented.</p>","PeriodicalId":77342,"journal":{"name":"Rays","volume":"31 1","pages":"21-4"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26273172","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
Giant posterior mediastinal liposarcoma invading the esophagus: a case report. 巨大后纵隔脂肪肉瘤侵袭食道1例。
Rays Pub Date : 2006-01-01
Alessandro Marolla, Alessandro Pardolesi, Pierpaolo Camplese, Roberto Politi, Rocco Sacco
{"title":"Giant posterior mediastinal liposarcoma invading the esophagus: a case report.","authors":"Alessandro Marolla,&nbsp;Alessandro Pardolesi,&nbsp;Pierpaolo Camplese,&nbsp;Roberto Politi,&nbsp;Rocco Sacco","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Giant liposarcoma is an unusual variant of mediastinal tumors. The case of a 73-year-old woman is reported. She presented with a posterior mediastinal tumor invading the third middle tract of the thoracic esophagus and the adventitia of the descending aorta, close to the posterior pericardium; a neoplastic thrombus 2cm in size was located in the upper left pulmonary vein. The tumor was completely excised by left thoracotomy, in extracorporeal circulation. The postoperative course was uneventful and the patient received adjuvant chemotherapy. She is currently alive after 8 months, disease-free. The natural history, pathology, and prognosis of the disease are reviewed and management of such lesions is discussed.</p>","PeriodicalId":77342,"journal":{"name":"Rays","volume":"31 1","pages":"17-9"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26273170","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
Sems (self expanding metal stents) in palliation of esophageal cancer dysphagia. 自膨胀金属支架在缓解食管癌吞咽困难中的应用。
Rays Pub Date : 2006-01-01
Annie Zanca, Pierfilippo Crucitti, Monica Pandolfi, Marilena Montesano, Armando Gabbrielli, Roberto Coppola
{"title":"Sems (self expanding metal stents) in palliation of esophageal cancer dysphagia.","authors":"Annie Zanca,&nbsp;Pierfilippo Crucitti,&nbsp;Monica Pandolfi,&nbsp;Marilena Montesano,&nbsp;Armando Gabbrielli,&nbsp;Roberto Coppola","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Symptomatic inoperable esophageal carcinoma represents a major clinical problem. With no treatment, swallowing deteriorates with a dramatic worsening of quality of life. At present, self-expanding metal stents (SEMS) are the most effective non surgical palliation in inoperable esophageal cancer. The different types of available SEMS, techniques, results and complications are discussed.</p>","PeriodicalId":77342,"journal":{"name":"Rays","volume":"31 1","pages":"67-71"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26273107","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
Endoscopic palliation of esophageal cancer. 内镜下食管癌姑息治疗。
Rays Pub Date : 2006-01-01
Maurizio Ferrante, Marcella Feliziani, Andrea Imperatori, Luca Ferraris, Giordano Bernasconi
{"title":"Endoscopic palliation of esophageal cancer.","authors":"Maurizio Ferrante,&nbsp;Marcella Feliziani,&nbsp;Andrea Imperatori,&nbsp;Luca Ferraris,&nbsp;Giordano Bernasconi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Endoscopic palliation is the most suitable approach to improve quality of life in patients with esophageal cancer since diagnosis is often made at an advanced stage, when radical treatment is unfeasible. Endoscopy offers several techniques to palliate dysphagia either by stenting the stenosis or by reducing the tumor mass with thermoablation. A small number of randomized controlled trials is available to compare the efficacy of different techniques and the ideal palliation has not been defined as yet. Recently, the development of self-expandable covered metal stents has rapidly gained ground in the endoscopy units throughout the world as a simple, single step procedure for palliation of dysphagia.</p>","PeriodicalId":77342,"journal":{"name":"Rays","volume":"31 1","pages":"3-7"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26273167","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
Postoperative management of elective esophagectomy for cancer. 择期食管癌切除术的术后处理。
Rays Pub Date : 2005-10-01
Paola Aceto, Elisabetta Congedo, Alexander Cardone, Luca Zappia, Germano De Cosmo
{"title":"Postoperative management of elective esophagectomy for cancer.","authors":"Paola Aceto,&nbsp;Elisabetta Congedo,&nbsp;Alexander Cardone,&nbsp;Luca Zappia,&nbsp;Germano De Cosmo","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Postoperative management after elective esophagectomy for cancer has not been standardized. Thoracoabdominal incision with associated pain, extended operative time with consequent extracellular fluid shifts, single lung ventilation, potential for prolonged postoperative mechanical ventilation and comorbidities in patients with esophageal cancer, all contribute to high perioperative risk. Respiratory problems remain the major cause of both mortality and morbidity after esophagectomy for cancer. A specific pulmonary disorder, acute respiratory distress syndrome (ARDS) occurs in 10-20% of patients after esophagectomy. ARDS mortality exceeds 50%. Atrial fibrillation, that complicates recovery in 20 to 25% of patients after esophagectomy, contributes to make outcome worse. Anesthesiologists should adopt strategies known to be able to optimize patient outcome. Decreased postoperative mortality and morbidity have been associated with epidural analgesia, bronchoscopy to clear persistent bronchial secretions, intraoperative fluid restriction and early extubation. It has been shown that setting up early respiratory physiotherapy and mobilitation may improve functional recovery.</p>","PeriodicalId":77342,"journal":{"name":"Rays","volume":"30 4","pages":"289-94"},"PeriodicalIF":0.0,"publicationDate":"2005-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26101921","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 cancer staging: the role of radiology. 食管癌分期:影像学的作用。
Rays Pub Date : 2005-10-01
Francesco Maria Caputo, Grazia Loretta Buquicchio
{"title":"Esophageal cancer staging: the role of radiology.","authors":"Francesco Maria Caputo,&nbsp;Grazia Loretta Buquicchio","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In esophageal cancer staging, the radiologic approach is represented by tumor identification, preoperative staging, and re-staging after neoadjuvant therapies. At present, while barium radiography shows a high sensitivity for early and advanced tumors, endoscopy is always necessary for confirmation. CT and MRI are the gold standard for preoperative staging of advanced (T4) esophageal cancer and for evaluation of distant metastasis; however they still show a low sensitivity in the study of possible regional lymph node involvement, in differentiating residual disease and scarring; in particular the esophageal wall cannot be carefully examined.</p>","PeriodicalId":77342,"journal":{"name":"Rays","volume":"30 4","pages":"309-14"},"PeriodicalIF":0.0,"publicationDate":"2005-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26101922","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
Rehabilitation in esophageal cancer. 食管癌的康复。
Rays Pub Date : 2005-10-01
Raffaele Gimigliano, Marianna Bertella, Francesca Gimigliano, Giovanni Iolascon
{"title":"Rehabilitation in esophageal cancer.","authors":"Raffaele Gimigliano,&nbsp;Marianna Bertella,&nbsp;Francesca Gimigliano,&nbsp;Giovanni Iolascon","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Cancer of the esophagus has an unfavorable prognosis with a five-year survival rate after radical surgery of less than 10%; early diagnosis is difficult. The appearance of symptoms, particulary dysphagia, is due to more than 2/3 tumor involvement of the esophageal circumference, already present in 2/3 of patients at diagnosis. Symptoms can be local and/or systemic; they can be physical, psychic, iatrogenic and evolutive. A careful rehabilitation program should follow these patients during the entire course of their disease The rehabilitation approach intends to define areas of intervention, short-term goals, possible achievements, role of health operators and overall verifications. Common problems of patients with esophageal cancer, are analyzed. A rehabilitation program including the patient care throughout the hospitalization period to improve his/her autonomy with respect to his/her social and familial activities, is illustrated.</p>","PeriodicalId":77342,"journal":{"name":"Rays","volume":"30 4","pages":"295-8"},"PeriodicalIF":0.0,"publicationDate":"2005-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26101920","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
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