Disease relevance of Esophagectomy

• PATIENTS AND METHODS: One hundred fifty five patients with resectable esophageal cancer were randomly assigned to perioperative G-CSF at standard doses (77 patients) or placebo (76 patients), administered from 2 days before until day 7 after esophagectomy [1].
• High-grade epithelial dysplasia is an indication for esophagectomy because of the prevalence of occult adenocarcinoma (43%) [2].
• OBJECTIVE: The safe resection margin in esophagectomy for esophageal squamous cell carcinoma (SCC) was determined based on the extent of epithelial and subepithelial accessory lesions from the main lesions of esophageal SCC [3].
• Dysphagia relief was similar in the CRT group vs. the CRT+E subgroup; however, a greater percentage of patients treated with chemoradiation alone had normal long-term swallowing function when compared to those patients also undergoing esophagectomy (100% vs. 73%) [4].
• CONCLUSIONS: Brain metastases from carcinomas of the esophagus are relatively uncommon (3.6% in the esophagectomy cohort) [5].

Psychiatry related information on Esophagectomy

• Gastropyloric motor activity and the effects of erythromycin given orally after esophagectomy [6].

High impact information on Esophagectomy

• Esophagectomy specimens were reevaluated by immunohistochemistry (monoclonal antibody against cytokeratin AE1/AE3) [7].
• PURPOSE: This phase II trial evaluated continuous-infusion cisplatin and fluorouracil (5-FU) with radiotherapy followed by esophagectomy [8].
• The suggested value of esophagectomy and superiority of preoperative CRT over CRT alone in this study should be tested in a randomized trial [9].
• RESULTS: In 72 patients with ESCC, intracellular MIF was overexpressed in esophagectomy specimens [10].
• In a prior phase II study, granulocyte colony-stimulating factor (G-CSF) was shown to improve leukocyte function and to reduce infection rates after esophagectomy [1].

Chemical compound and disease context of Esophagectomy

• EXPERIMENTAL DESIGN: Fifty-two patients with resectable esophageal cancers (cT2-4, Nx, and M0) received neoadjuvant radiochemotherapy (cisplatin, 5-5-fluorouracil, 36 Gy) followed by transthoracic en bloc esophagectomy [11].
• METHODS AND MATERIALS: Thirty-one patients with localized esophageal adenocarcinoma were enrolled in a Phase II study involving high dose radiation and concurrent 5-fluorouracil (5-FU)/mitomycin-C with or without esophagectomy [12].
• METHODS: Reflux symptom evaluation, endoscopy, and simultaneous 24-h pH and bilirubin monitoring in the cervical esophagus were performed in 25 patients who underwent Ivor Lewis esophagectomy, intrathoracic esophagogastrostomy, and digital dilation of the pyloric ring as treatment for esophageal cancer [13].
• SETTING: Yamaguchi University School of Medicine, Kogushi, Japan. PATIENTS: A random sample of 21 patients selected from 79 patients with esophageal cancer during the period from May 1988 to August 1993 received the intrathoracic stomach after subtotal esophagectomy [14].
• Sections of formalin-fixed and paraffin-embedded tissue from 31 esophagectomy specimens were immunostained for ER-B using the immunoperoxidase technique, and the percent of positive cells in areas of Barrett's metaplasia negative for dysplasia (ND), low-grade dysplasia (LGD), high-grade dysplasia (HGD) and adecocarcinoma, (CA) were recorded [15].

Biological context of Esophagectomy

• Comparison of initial distribution volume of glucose and intrathoracic blood volume during hemodynamically unstable States early after esophagectomy [16].
• Thus, the induction of anti-inflammatory cytokines and the downregulation of pro-inflammatory cytokines by G-CSF might be a promising adjuvant treatment of infectious complications in patients undergoing esophagectomy [17].
• Moreover, the severe and sustained decrease in Factor XIII activity may be related to poor wound healing after esophagectomy [18].
• The effects of dopamine infusion on the postoperative energy expenditure, metabolism, and catecholamine levels of patients after esophagectomy [19].
• This was done by mounting sections of human epithelia obtained at the time of esophagectomy in Ussing chambers and monitoring the change in electric resistance (R) on luminal acidification with 60 mM HCl [20].

Anatomical context of Esophagectomy

• METHODS AMD MATERIALS: In 58 patients with esophageal cancer treated with subtotal esophagectomy and radical lymph node dissection the preoperative MR (n = 58) images and CT scans (n = 41) were reviewed [21].
• Thus, in this study, administration of Filgrastim stimulated neutrophil function in patients undergoing esophagectomy, and it might be effective in reducing infectious complications related to the surgical procedure [22].
• After thoracic esophagectomy was performed, granulocyte count and serum G-CSF concentration rapidly normalized [23].
• Peak IL-6 concentration observed in a patient who underwent esophagectomy was about 100-fold greater in fluid drained from the thorax than in the peripheral blood [24].
• ConA- and PHA-stimulated lymphocyte proliferation decreased significantly 7 d after esophagectomy (P<0.05), but was unchanged in the patients receiving gastrectomy [25].

Associations of Esophagectomy with chemical compounds

• METHODS: Thirty-two patients underwent manometry, simultaneous 24-hour pH and bilirubin monitoring, and endoscopy with biopsy 3 to 10.4 years after esophagectomy [26].
• Sixteen patients undergoing total esophagectomy were evenly randomized and received TPN without or with L-carnitine supplementation (74 mumol.kg-1.d-1) during 11 postoperative days [27].
• As neoadjuvant CT, cisplatin of 50 mg/body/week was administered 2-5 times (100-250 mg in total) until 7-10 days before subtotal esophagectomy [28].
• Formalin-fixed and paraffin-embedded tissue sections from esophageal biopsies and esophagectomy specimens with BM, with and without dysplasia and carcinoma, were immunostained for Fas and FasL using the immunoperoxidase technique [29].
• METHODS: Twenty elective patients scheduled for thoracoabdominal esophagectomy under general anesthesia with propofol infusion were randomly allocated to receive either intravenous or epidural boluses of 50-100 micrograms fentanyl in a double-blind fashion to maintain hemodynamic stability [30].

Gene context of Esophagectomy

• Depression of Th2-type cytokine production was more profound after transthoracic than after transhiatal esophagectomy (IL-4, P=.005; IL-13,P=.007) [31].
• Surgical specimens from 75 patients with esophageal adenocarcinoma treated with esophagectomy were immunostained for endoglin, CD31, and VEGF [32].
• Hence postoperative serum IL-6, IL-8, and HGF levels may be useful predictors of infection after esophagectomy [33].
• METHODOLOGY: We studied p16, cyclin D1, and pRB expression using immunohistochemistry in the resected specimens of 156 patients who underwent curative esophagectomy [34].
• We evaluated 126 patients who underwent esophagectomy in the National Taiwan University Hospital, and found that the status of p53 overexpression was significantly influenced by presence of codon 72 polymorphisms [35].

Analytical, diagnostic and therapeutic context of Esophagectomy

• In a prospective, randomized study, patients having undergone esophagectomy or gastrectomy for cancer received jejunal infusions of oligopeptide-based or whole-protein-based complete formulas (OPD and WPD, respectively) during two 9-h periods on 2 consecutive days in a crossover design [36].
• The study reported by Kelsen et al. included 440 patients with esophageal adenocarcinoma (n = 236) or SCC (n = 204) randomized to either preoperative chemotherapy plus esophagectomy or to esophagectomy alone [37].
• The patients in the chemoradiotherapy group received 5-fluorouracil combined with cisplatin plus 60 Gy of radiation, and those in the surgery group received an esophagectomy with radical node dissection [38].
• The purpose of this study was to determine the effect of epidural bupivacaine combined with morphine on extubation time, postoperative analgesia, respiration, and hemodynamics in patients undergoing esophagectomy [39].
• CONCLUSIONS: Esophagectomy and aggressive upper mediastinal lymphadenectomy cause a deterioration in TBF that is partially attenuated by PGE1 [40].

References