1/9. Esophageal carcinoma showing a long stricture due to prominent lymphatic permeation: report of a case.Some esophageal diseases such as carcinoma, esophagitis, and collagen diseases have often been reported to show a diffusely thickened esophageal wall in the roentogenogram findings. In the current report, a preoperative upper gastrointestinal series and an endoscopic examination showed a diffusely infiltrative type carcinoma, but other examinations did not suggest any diseases such as esophagitis or collagen diseases which might cause a thickening of the esophageal wall or a constriction of the esophagus. A postoperative histological examination revealed the primary carcinoma to remain only within the mucosal layer, while a large degree of lymphatic vessel permeation reached the adventitia over a wide area. An extraordinary degree of lymphatic permeation spread through the esophageal wall, and stromal fibrosis developed as a result of such lymphatic permeation. These histological phenomena might thus have led to the macroscopic appearance of infiltrative type esophageal carcinoma.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/9. Microvascular "supercharged" cervical colon: minimizing ischemia in esophageal reconstruction.Traditional colonic reconstruction of the esophagus is performed by cervical transposition of an isolated segment of colon with the vascular supply derived from one of the mesenteric colic vessels. The transposed cervical portion of the colon is farthest from the vascular supply and is at risk of ischemic injury. Despite notable risk of ischemic complications to the colonic neoesophagus, reports advocating a "supercharged" microvascular augmentation of the vascular supply to the cervical portion of the colon remain few in number. Herein, the ischemic complications associated with traditional transposition of the colon for esophageal reconstruction are reviewed, and avoidance by microvascular "supercharging" of the cervical colon is advocated under particular circumstances. The authors present a case of colonic interposition for esophageal replacement requiring a cervical microvascular anastomosis for survival of the transferred colon.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/9. Three-dimensional CT imaging of aneurysm of aberrant right subclavian artery.We report a case of an aneurysm originating from an aberrant right subclavian artery, which was incidentally found as a compression deformity of the upper esophagus on a barium study in a 46-year-old man. Computed tomography (CT) clearly demonstrated the aneurysm of the aberrant right subclavian artery. In particular, reconstructed three-dimensional CT (3D-CT) was valuable in evaluating the positional relationships between the anomalous vessel with aneurysm and other structures.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/9. Prefabrication of jejunum for challenging reconstruction of cervical esophagus.A significant benefit exists for a jejunal replacement of the cervical esophagus, if indicated. The absence of available recipient vessels may impede free tissue transfer. If vascular induction between a vascular carrier and the selected jejunal segment is done as a kind of flap prefabrication, the jejunal interposition flap can be used without the need for complex microsurgery.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/9. Dysphagia lusoria: a complication following gastric bypass surgery?A 23-year-old Caucasian female presented with progressive dysphagia beginning 5 months following laparoscopic gastric bypass for morbid obesity. She was diagnosed with an aberrant right subclavian artery and underwent a combined right supraclavicular approach and left thoracotomy for resection, with reimplantation of the vessel to the ipsilateral carotid artery. The patient had complete resolution of symptoms.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/9. esophageal stenosis after coil embolization of an aortopulmonary collateral artery: report of a very unusual cause.A 10-year-old boy who had previously undergone surgery for tetralogy of fallot, pulmonary atresia, and ventricular septal defect was admitted with difficulty in swallowing and significant failure to thrive. His history included that he had 2 angiographically detected aberrant pulmonary arteries extending from the descending aorta to the right and left lungs, respectively. Both collaterals had been ligated during the corrective surgery; however, early postoperative evaluation revealed that the vessel that crossed behind the esophagus to the left lung had become recanalized. Coil embolization was performed to occlude this collateral. The patient had begun to develop swallowing difficulties 2 years after the embolization. Esophagography revealed a significant stricture in the middle of the esophagus, just anterior to the location of the coil in the vessel behind. The patient underwent a program of esophageal dilatation. This was successful, and he regained normal swallowing ability. To our knowledge, no similar case of esophageal stenosis has been reported in the English literature. We believe that inflammation surrounding the coiled aberrant artery, presumably caused by injury during the corrective surgery and resulting in hemorrhage, led to fibrosis around the vessel. This fibrosis also involved the adjacent esophageal wall, thus causing progressive stenosis.- - - - - - - - - - ranking = 3keywords = vessel (Clic here for more details about this article) |
7/9. Gastric vascular pedicle patch esophagoplasty for stricture.Three patients with Barrett's esophagus and strictures between the middle and distal thirds of the esophagus, of 5 to 26 years duration at the time of the plasty, were treated with an infradiaphragmatic Nissen fundoplication and gastric vascular pedicle patch esophagoplasty, based on the right gastroepiploic vessels. Follow-up for 2 patients has been 6 and 7 years; both patients are asymptomatic except for periodic mild dysphagia in 1. The third patient developed cancer after 1 symptom-free year, and had esophagectomy with colon interposition. The results of this operation justify its use in recalcitrant lower intrathoracic esophageal strictures that do not respond to antireflux operation or dilation.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
8/9. Antral patch esophagoplasty. A new procedure for acid-peptic esophageal stricture.Antral patch esophagoplasty is a new procedure for intractable fibrous stricture of the esophagus secondary to acid-peptic reflux. A full-thickness patch of gastric antrum, supplied by a pedicle based on the left gastroepiploic vessels, is inserted, mucosal surface to lumen, into the opened stricture. A fundoplication is done below the esophagoplasty to prevent reflux. The functional results were excellent in five of six patients. The procedure may have application also in other types of benign esophageal stricture.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
9/9. Revascularization of the ischemic colon transplant using the internal mammary vessels.We describe a successful reconstruction of the esophagus with the isoperistaltic right colon and terminal ileum, which had very poor continuity of the marginal artery. The stomach and the left colon were not available because of corrosive injury and intraabdominal adhesions. The blood supply of the ischemic transplant was augmented by anastomosis of the internal mammary vessels to the iliocolic vessels.- - - - - - - - - - ranking = 6keywords = vessel (Clic here for more details about this article) |