The widespread popularity of new surgical technologies such as laparoscopy, thoracoscopy and robotics has led many surgeons to treat esophageal diseases with these methods. The expected benefits of minimally invasives...The widespread popularity of new surgical technologies such as laparoscopy, thoracoscopy and robotics has led many surgeons to treat esophageal diseases with these methods. The expected benefits of minimally invasivesurgery(MIS) mainly include reductions of postoperative complications, length of hospital stay, and pain and better cosmetic results. All of these benefits could potentially be of great interest when dealing with the esophagus due to the potentially severe complications that can occur after conventional surgery. Moreover, robotic platforms are expected to reduce many of the difficulties encountered during advanced laparoscopic and thoracoscopic procedures such as anastomotic reconstructions, accurate lymphadenectomies, and vascular sutures. Almost all esophageal diseases are approachable in a minimally invasive way, including diverticula, gastro-esophageal reflux disease, achalasia, perforations and cancer. Nevertheless, while the limits of MIS for benign esophageal diseases are mainly technical issues and costs, oncologic outcomes remain the cornerstone of any procedure to cure malignancies, for which the long-term results are critical. Furthermore, many of the minimally invasive esophageal operations should be compared to pharmacologic interventions and advanced pure endoscopic procedures; such a comparison requires a difficult literature analysis and leads to some confounding results of clinical trials. This review aims to examine the evidence for the use of MIS in both malignancies and more common benign disease of the esophagus, with a particular emphasis on future developments and ongoing areas of research.展开更多
Jejunal diverticula are quite rare.Furthermore,small bowel diverticular disease resulting in enteroliths can lead to complications necessitating surgical intervention.In this manuscript,we report two presentations of ...Jejunal diverticula are quite rare.Furthermore,small bowel diverticular disease resulting in enteroliths can lead to complications necessitating surgical intervention.In this manuscript,we report two presentations of jejunal diverticulum with complications from enteroliths followed by a review of the literature.The first case was that of a 79-year-old male who presented with abdominal pain and was found,on computed tomography scan,to have evidence of intestinal perforation.A laparotomy showed that he had perforated jejunal diverticulitis.The second case was that of an 89-year-old female who presented with recurrent episodes of bowel obstruction.A laparotomy showed that she had an enterolith impacted in her jejunum in the presence of significant diverticular disease.Although a rare entity,familiarity with jejunal diverticular disease,its complications,and its management,should be part of every surgeon's base of knowledge when considering abdominal pathology.展开更多
文摘The widespread popularity of new surgical technologies such as laparoscopy, thoracoscopy and robotics has led many surgeons to treat esophageal diseases with these methods. The expected benefits of minimally invasivesurgery(MIS) mainly include reductions of postoperative complications, length of hospital stay, and pain and better cosmetic results. All of these benefits could potentially be of great interest when dealing with the esophagus due to the potentially severe complications that can occur after conventional surgery. Moreover, robotic platforms are expected to reduce many of the difficulties encountered during advanced laparoscopic and thoracoscopic procedures such as anastomotic reconstructions, accurate lymphadenectomies, and vascular sutures. Almost all esophageal diseases are approachable in a minimally invasive way, including diverticula, gastro-esophageal reflux disease, achalasia, perforations and cancer. Nevertheless, while the limits of MIS for benign esophageal diseases are mainly technical issues and costs, oncologic outcomes remain the cornerstone of any procedure to cure malignancies, for which the long-term results are critical. Furthermore, many of the minimally invasive esophageal operations should be compared to pharmacologic interventions and advanced pure endoscopic procedures; such a comparison requires a difficult literature analysis and leads to some confounding results of clinical trials. This review aims to examine the evidence for the use of MIS in both malignancies and more common benign disease of the esophagus, with a particular emphasis on future developments and ongoing areas of research.
文摘Jejunal diverticula are quite rare.Furthermore,small bowel diverticular disease resulting in enteroliths can lead to complications necessitating surgical intervention.In this manuscript,we report two presentations of jejunal diverticulum with complications from enteroliths followed by a review of the literature.The first case was that of a 79-year-old male who presented with abdominal pain and was found,on computed tomography scan,to have evidence of intestinal perforation.A laparotomy showed that he had perforated jejunal diverticulitis.The second case was that of an 89-year-old female who presented with recurrent episodes of bowel obstruction.A laparotomy showed that she had an enterolith impacted in her jejunum in the presence of significant diverticular disease.Although a rare entity,familiarity with jejunal diverticular disease,its complications,and its management,should be part of every surgeon's base of knowledge when considering abdominal pathology.
