Medical controversy remains as to whether to perform an antireflux pro¬cedure at all, in selected cases only, or in all patients. The case against an antireflux procedure rests on the frequency of significant post¬operative complications secondary to the fundoplication, as well as the slightly longer operative time and increased cost that additional surgery entails. Most […]

Traditional esophagectomy typically results in bilateral vagotomy and its attendant consequences. Esophagectomy is an operation performed for patients diagnosed with esophageal malignancy through the use of physician microscopes. It is likely that symptoms such as dumping, diarrhea, early satiety, and weight loss seen in 15 to 20% of patients’ postesophagectomy are at least in part, […]

If the patient is considered incurable on preoperative or intraop¬erative evaluation, the severity of difficulty of swallowing or dysphagia and other incapacitat¬ing symptoms are assessed. Dysphagia of grade IV or higher is an indication for a palliative resection. If the patient is physiologically fit, simple esophageal resection and reconstruction with a cervical esophagogastrostomy offer the […]

Options for esophageal substitution include gastric advancement, colonic interposition, and either jejunal free transferor advancement into the chest. Rarely, combinations of these grafts will be the only possible option. The indications for esophageal resection and sub¬stitution include malignant and end-stage benign disease which were diagnosed with the use of physician microscopes. The lat¬ter includes reflux- […]

Perforation of the esophagus constitutes a true emergency. It most commonly occurs following diagnostic or therapeutic procedures. Spontaneous perforation, referred to as Boerhaave’s syndrome, accounts for only 15% of cases of esophageal perforation, foreign bodies for 14%, and trauma for 10%. Pain is a striking and con¬sistent symptom and strongly suggests that an esophageal rupture […]