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At least 775 records · Page 43Linked to original sources
PubMed1998

[Results of the surgical treatment of severe caustic pharyngo-esophageal stenosis. The value of complete reconstruction of the pharynx by transposition of the ileum and colon].

STUDY AIM: The aim of this study was to report the results of pharyngoesophageal reconstruction in extensive corrosive strictures and to describe an original conception concerning extensive chemical burns of the pharynx with involvement of the epiglottis, oro-hypopharyngeal junction and cricopharyngeal pinchcock. PATIENTS AND METHODS: A personal series of 253 esophageal reconstructions using the colon and ileum is reported. In 124 patients, the cervical anastomosis of the graft was performed at the level of the pharynx, and these cases with extensive pharyngeal lesions were the basis of this study. The anastomosis was performed with the hypopharynx in 27 patients, with the oropharynx in nine and a total reconstruction of the pharynx or "pharyngoplasty" was carried out in 69 patients. The pharyngoplasty was classified according to the approach, in anterior, posterior, lateral, superior (transmandibular) and inferior. In high strictures with epiglottic injury, epiglottectomy was necessary in order to prevent recurrence. A visceral pharyngoplasty was performed in 61 patients, using the colon in 42 and the ileum in 19, a skin reconstruction in six patients and a myocutaneous flap in two. RESULTS: The global postoperative mortality rate was 4.7%. Stenosis of the cervical anastomosis occurred in 4.9% of the whole series. With a follow-up from 6 months to 10 years, 70% of the patients resumed a normal oral diet, 21% had mild symptoms and 7% had poor results (patients with tracheostomy and gastrostomy). CONCLUSION: Extensive chemical burns of the pharynx are very severe and their treatment very difficult. For the author, total visceral pharyngeal reconstruction is considered to be the procedure of choice, using ileopharyngoplasty with realization of an ileal pouch. Good results were obtained in 70% of the patients with extensive corrosive strictures.

Anastomosis, Surgical↗
PubMed2003

Kinetics of dodecanoic acid adsorption from caustic solution by activated carbon.

This study examines the influences of adsorbent porosity and surface chemistry and of carbon dosage on dodecanoic acid adsorption kinetics from aqueous and 2 M NaOH solutions as batch adsorption processes. Both adsorbents are steam-activated carbons prepared from either coconut or coal precursors. Prior to use the adsorbents were washed in deionized water or 2 M NaOH. Mass transfer coefficients and effective overall diffusion coefficients indicate a minor contribution from adsorbent porosity. In contrast, high surface oxygen content impedes transport to and into the adsorbent structure. Carbon dosage shows a proportional increase in transport coefficients with increasing mass; these coefficients are constant when normalized per unit mass. Neither water nor NaOH treatment of the adsorbents has a significant influence on dodecanoic acid adsorption kinetics. Molecular and Knudsen diffusion coefficients are defined to demonstrate that the overall effective diffusion coefficient values and the diffusion process are controlled by surface diffusion.

Journal Article↗
PubMed1986

Experience with esophageal stenting for caustic burns in children.

Seven children with deep circumferential esophageal burns were treated with antibiotics, steroids, and intraluminal silastic stents. Strictures did not develop if the esophagus was healed at the time the stent was removed. However, strictures developed if healing was incomplete. Esophageal stenting needs to be continued until healing has been demonstrated endoscopically.

Anti-Bacterial Agents↗
PubMed1990

[A new treatment concept for severe caustic and thermal burns of the eyes].

Combined surgical and drug therapy has proved efficacious in the treatment of severe eye burns. Initially, necrotic epibulbar tissue is excised. The sclera, denuded over a large area and in many cases ischemic, is covered with tenon flaps, prepared and advanced from the undamaged parabulbar connective tissue. For several months, artificial epithelium is used to protect the denuded and to a large extent acellular corneal stroma. Subsequently drug therapy, including corticosteroids, Healon, and prostaglandin synthesis inhibitors, is instituted to reduce the inflammatory reaction of the burned anterior segment. Regeneration of the conjunctival and later also the corneal epithelia may be improved by epidermal growth factor, autologous fibronectin, and proteinase inhibitors (Trasylol). This therapy avoids some complications which could not previously be influenced, and creates more favorable conditions for later corneal grafts.

Administration, Topical↗
PubMed1997

Esophageal perforation and caustic injury: management of perforated esophageal cancer.

Perforation of esophageal cancer is an unusual complication that most often results from instrumentation. The management of this condition must be individualized on the basis of the patient's condition and the stage of the cancer. For patients who are otherwise well and have localized disease, a standard resection is performed. Stent placement and esophageal exclusion are sometimes used for patients in good condition but in whom resection is not feasible. Supportive care alone is reserved for patients who have end-stage disease or are otherwise not candidates for aggressive therapy. Although the overall mortality rate is 50%, the risk for patients who undergo resection is less than 10%. This risk is similar to that found in patients undergoing elective resection and supports the concept that aggressive therapy should be pursued in highly selected patients with perforated esophageal cancers.

Esophageal Neoplasms↗