Endoscopic Treatment of Premalignant and Early Esophageal Malignancy
Indications (low risk) High risk Unifocal (limited or focal), flat HGD Multifocal HGD, HGD with nodules Type I, IIa < 2 cm, IIb, IIc < 1 cm Type I, II > 3 cm, type III Well-…
Pathogenesis of Gastric Cancer
Fig. 6.1 Precursor lesion of intestinal type gastric cancer – dysplasia. (a) Low-grade dysplasia. Pseudostratification of nuclei. Nuclei are elongated and mostly basally orientated. Few mitotic figures. (b) High-grade dysplasia….
Minimally Invasive Feeding Tube and Esophageal Stent Placement
Step Action 1 Insert endoscope 2 Dilate to 16 m with balloon dilator, if necessary 3 Place hemoclip 2 cm at planned distal end of stent 4 Insert wire and…
Thoracoscopic Enucleation of Esophageal Benign Tumors
Fig. 16.1 Arrangement of ports in thoracoscopic approach. AAL anterior axillary line, MAL midaxillary line, PAL posterior axillary line Fig. 16.2 The esophageal tumor is pushed away from the esophageal…
Multimodality Therapy in Gastric Cancer
Treatment arms Primary end point Secondary end points MAGIC [3] Surgery alone Epirubicin 50 mg/m2 day 1 5-year OS 5-year PFS Cisplatin 60 mg/m2 day 1 HR 0.75 HR 0.66…
The Volume-Outcome Relationship, Standardized Clinical Pathways, and Minimally Invasive Surgery for Esophagectomy
Author ECP patients LOS (PC) (days) LOS (ECP) (days) Mortality (PC) (%) Mortality (ECP) (%) Morbidity (PC) (%) Morbidity (ECP) (%) Zehr et al. (1991–1997) [24] 96 13.6 ± 6.9 9.5 ± 2.8 3.6…
Goals of Surgical Therapy for Esophageal Cancer
Fig. 4.1 (a) The lymphatics of the esophagus are distributed in the form of a submucosal and a paraesophageal plexus that can both drain directly into the periesophageal lymph nodes….
Pathogenesis of Esophageal Cancer
Risk factor Risk Tobacco 4–8× Alcohol 1.3–8× Alcohol dehydrogenase 4× Fruits and vegetables 0.53–0.56× Poverty 8× Gastroesophageal reflux 7.7× Obesity 3.1× Helicobacter pylori infection 0.56–1.1× Squamous Cell Carcinoma Worldwide squamous…
Optimization of Patients for Esophageal Cancer Surgery
Cardiac disease Pulmonary disease Liver disease VTE Nutrition Frailty Risk factors CAD COPD/asthma ETOH Hx of VTE > 10 % Weight loss Age > 65 Prior MI Exercise intolerance Hepatitis Immobility…
