scholarly journals Evaluation of urgent esophagectomy in esophageal perforation

2014 ◽  
Vol 27 (4) ◽  
pp. 247-250 ◽  
Author(s):  
José Luis Braga de AQUINO ◽  
José Gonzaga Teixeira de CAMARGO ◽  
Gustavo Nardini CECCHINO ◽  
Douglas Alexandre Rizzanti PEREIRA ◽  
Caroline Agnelli BENTO ◽  
...  
Keyword(s):  
Digestive Tract ◽  
Esophageal Perforation ◽  
Clinical Status ◽  
Esophageal Resection ◽  
Local Conditions ◽  
Therapeutic Choice ◽  
Anastomotic Fistula ◽  
Transmediastinal Esophagectomy

BACKGROUND: Esophageal trauma is considered one of the most severe lesions of the digestive tract. There is still much controversy in choosing the best treatment for cases of esophageal perforation since that decision involves many variables. The readiness of medical care, the patient's clinical status, the local conditions of the perforated segment, and the severity of the associated injuries must be considered for the most adequate therapeutic choice. AIM: To demonstrate and to analyze the results of urgent esophagectomy in a series of patients with esophageal perforation. METHODS: A retrospective study of 31 patients with confirmed esophageal perforation. Most injuries were due to endoscopic dilatation of benign esophageal disorders, which had evolved with stenosis. The diagnosis of perforation was based on clinical parameters, laboratory tests, and endoscopic images. The main surgical technique used was transmediastinal esophagectomy followed by reconstruction of the digestive tract in a second surgical procedure. Patients were evaluated for the development of systemic and local complications, especially for the dehiscence or stricture of the anastomosis of the cervical esophagus with either the stomach or the transposed colon. RESULTS: Early postoperative evaluation showed a survival rate of 77.1% in relation to the proposed surgery, and 45% of these patients presented no further complications. The other patients had one or more complications, being pulmonary infection and anastomotic fistula the most frequent. The seven patients (22.9%) who underwent esophageal resection 48 hours after the diagnosis died of sepsis. At medium and long-term assessments, most patients reported a good quality of life and full satisfaction regarding the surgery outcomes. CONCLUSIONS: Despite the morbidity, emergency esophagectomy has its validity, especially in well indicated cases of esophageal perforation subsequent to endoscopic dilation for benign strictures.

scholarly journals The Observatorio Astronómico Nacional - Tonantzintla: Site Evaluation

2009 ◽  
Vol 5 (S260) ◽  
Author(s):  
H.M. Hernández-Toledo ◽  
L.A. Martínez-Vázquez ◽  
A. Pani-Cielo
Keyword(s):  
Ccd Photometry ◽  
Local Conditions ◽  
Astronomy Education ◽  
Site Evaluation ◽  
New Instrumentation ◽  
Sky Conditions ◽  
Alternative Solutions ◽  
Term Monitoring

AbstractThe objective of this contribution is to present some results of an evaluation on the local conditions at the site that were considered in order to propose that the Observatorio Astronómico Nacional, Tonantzintla, (OAN-Tonantzintla) become a National Facility for Astronomy Education. The evaluation included a quantitative diagnostic (CCD photometry) on the quality of the local sky. The attributes of the 1-m telescope, the current instrumentation and a well planned upgrading that includes new instrumentation is considered at the basis for a successful transition maintaining the attractiveness of the site for astronomy education. A 3-year upgrading program actually in progress at UNAM is providing funding for that purpose. Physics and astronomy programs at college and graduated levels at UNAM will benefit from this, yielding clear connections among astronomy researchers and educators and students at various levels. Although the OAN-Tonantzintla faces the danger of deteriorating its sky conditions, we are maintaining awareness of the night sky characteristics in long-term monitoring campaigns and encouraging the local authorities to find alternative solutions to this problem.

Effects of prolonged intensive care unit stay on quality of life and long-term survival after transthoracic esophageal resection

2006 ◽  
Vol 34 (2) ◽  
pp. 354-362 ◽  
Author(s):  
H A. Cense ◽  
J B. F. Hulscher ◽  
A G. E. M. de Boer ◽  
D A. Dongelmans ◽  
H W. Tilanus ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Unit Stay ◽  
Esophageal Resection ◽  
Term Survival ◽  
Long Term Survival

P197 LONG-TERM HEALTH-RELATED QUALITY OF LIFE AFTER BENIGN ESOPHAGEAL PERFORATION

2019 ◽  
Vol 32 (Supplement_2) ◽  
Author(s):  
Knepper Laura ◽  
Brinkmann Sebastian ◽  
F Fuchs Hans ◽  
H Hoelscher Arnulf ◽  
Kuhr Kathrin ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Esophageal Perforation ◽  
Health Related Quality ◽  
Long Term Outcome ◽  
Related Quality ◽  
Long Term Follow Up ◽  
Health Related

Abstract Aim This study aims to evaluate long-term outcome and health related quality of life in patients with benign esophageal perforations. Background and Methods Esophageal perforation is associated with high morbidity and mortality. In addition to surgical treatment, endoscopic endoluminal stent placement and endoscopic vacuum therapy (EVT) are established methods in the management of this emergency condition. As health-related quality of life (HRQoL) is becoming a major issue in the evaluation of any therapeutic intervention not much is known about HRQoL, particular in the long-term follow-up of patients treated for benign esophageal perforation with different treatment strategies. Patients treated for benign esophageal perforation at the University Hospital Cologne from January 2003 to December 2014 were therefore investigated. Primary outcome and management of esophageal perforation were documented and long-term quality of life was assessed using the Gastrointestinal Quality of Life Index (GIQLI), the Health-Related Quality of Life Index (HRQL) for patients with gastroesophageal reflux disease (GERD) and the European Organization for Research and Treatment of Cancer (EORTC) questionnaires for general and esophageal cancer specific QoL (QLQ-C30 and QLQ-OES18). Results Patients were divided based on primary treatment into an endoscopic (46.5%), surgical (34.5%) and conservative treatment group (19%). Short- and long-term outcome, as well as quality of life were compared. HRQoL was measured after a median follow-up of 49 months. HRQoL was generally reduced in patients with benign esophageal perforation. Endoscopically treated patients showed the highest GIQLI overall score and highest EORTC general health status, followed by the conservative and the surgical group. Conclusion HRQoL in patients with benign esophageal perforation is reduced even in the long-term follow-up. Temporary stent or EVT is effective and provides a good alternative to surgery not only in the short-term but also in the long-term follow-up.

Esophageal Resection for Cancer of the Esophagus: Long-Term Function and Quality of Life

1997 ◽  
Vol 63 (6) ◽  
pp. 1568-1571 ◽  
Author(s):  
Allison J McLarty ◽  
Claude Deschamps ◽  
Victor F Trastek ◽  
Mark S Allen ◽  
Peter C Pairolero ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Esophageal Resection ◽  
Term Function ◽  
Cancer Of The Esophagus

scholarly journals Lokalne instytucje pomocy społecznej w procesie aktywizacji społeczno-zawodowej bezrobotnych kobiet

2012 ◽  
pp. 73-91
Author(s):  
Izabela Książkiewicz
Keyword(s):  
At Risk ◽  
Social Programs ◽  
The European Union ◽  
Local Conditions ◽  
New Approach ◽  
Large Cities ◽  
Central Management ◽  
The Welfare State

Contemporary theories of politics, and social assistance – stress that the effectiveness of social programs in the field of community work with groups at risk of marginalization processes is determined by quality of service provided in this area at the level of local institutions. The financial crisis of the welfare state – has highlighted the weakness of the central management of social programs, at the level of individual regions, and thus the need for a new approach to the problems of the excluded. Long-term unemployment, disability, many children and sex are those factors that promote the processes of exclusion – in Poland, a group particularly at risk are women who live outside large cities. The analysis shows that the appropriate support by local aid institutions – raises the prospect of becoming independent women still excluded from the labor market. However, in order to be successful, must be complied with certain conditions into account the local conditions of socio-economic potential. A chance for the preparation of programs targeted to a specific group, including its characteristics and needs – are carried out from 2008 projects under the Human Capital Operational Programme, funded by the European Union. In this elaboration I present the experience of three municipalities voivodeship with the implementation of programs for the group of unemployed women.

Long-term Function and Quality of Life After Esophageal Resection for Cancer and Barrett's

2005 ◽  
Vol 85 (3) ◽  
pp. 649-656 ◽  
Author(s):  
Claude Deschamps ◽  
Francis C. Nichols ◽  
Stephen D. Cassivi ◽  
Mark S. Allen ◽  
Peter C. Pairolero
Keyword(s):  
Quality Of Life ◽  
Esophageal Resection ◽  
Term Function

scholarly journals Long Term Monitoring of Nutritional, Clinical Status and Quality of Life in Head and Neck Cancer Patients

2015 ◽  
Vol 28 (3) ◽  
pp. 200-214 ◽  
Author(s):  
Eva Malá ◽  
Eva Vejražková ◽  
Jana Bielmeierová ◽  
Martin Jindra ◽  
Milan Vošmik ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Clinical Status ◽  
Long Term Monitoring ◽  
Term Monitoring

scholarly journals Short- and Long-Term Follow-Up of Patients with Benign Esophageal Perforation

2020 ◽  
Author(s):  
Sebastian Brinkmann ◽  
Laura Knepper ◽  
Hans Friedrich Fuchs ◽  
Arnulf Heinrich Hoelscher ◽  
Kathrin Kuhr ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Esophageal Perforation ◽  
Related Quality ◽  
Long Term Follow Up ◽  
Health Related ◽  
Quality Of Life Index ◽  
Short And Long Term

Abstract Background Esophageal perforation is associated with high morbidity and mortality. In addition to surgical treatment, endoscopic endoluminal stent placement and endoscopic vacuum therapy (EVT) are established methods in the management of this emergency condition. As health-related quality of life (HRQoL) is becoming a major issue in the evaluation of any therapeutic intervention not much is known about HRQoL, particular in the long-term follow-up of patients treated for benign esophageal perforation with different treatment strategies. Methods Patients treated for benign esophageal perforation at the University Hospital Cologne from January 2003 to December 2014 were included. Primary outcome and management of esophageal perforation were documented and long-term quality of life was assessed using the Gastrointestinal Quality of Life Index (GIQLI), the Health-Related Quality of Life Index (HRQL) for patients with gastroesophageal reflux disease (GERD) and the European Organization for Research and Treatment of Cancer (EORTC) questionnaires for general and esophageal cancer specific QoL (QLQ-C30 and QLQ-OES18). . Results 58 patients were included in the study. Based on primary treatment patients were divided into an endoscopic (n = 27; 46.6%), surgical (n = 20; 34.5%) and conservative group (n = 11; 19%). Short- and long-term outcome, as well as quality of life were compared. HRQoL was measured after a median follow-up of 49 months HRQoL was generally reduced in patients with benign esophageal perforation. Endoscopically treated patients showed the highest GIQLI overall score and highest EORTC general health status, followed by the conservative and the surgical group. Conclusion HRQoL in patients with benign esophageal perforation is reduced even in the long-term follow-up. Temporary stent or EVT is effective and provides a good alternative to surgery not only in the short-term but also in the long-term follow-up.

Sign in / Sign up

Export Citation Format

Share Document