Esophagectomy in Scleroderma: Report of a Case

Yekeler, Erdal; Gürsan, Nesrin

doi:10.1159/000161565

Cited by 6 publications

(4 citation statements)

References 21 publications

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“…One of them is esophageal stricture, which finally leads to disordered motility with contraction amplitudes or loss of peristalsis. These end-stage abnormalities result from a variety of esophageal diseases, such as caustic injury (2,3), chronic reflux disease (4), achalasia (5), giant mass in the esophagus (6), or scleroderma of connective tissue disease (7).…”

Section: Factors Leading To Esophageal Failure In Benign Diseasementioning

confidence: 99%

Esophagectomy with gastric conduit reconstruction for benign disease: extreme but important

Guo

Yang

2018

Ann. Transl. Med.

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Esophagectomy is usually performed to resect esophageal cancer. However, there are numerous other indications for esophagectomy, including Barrett's esophagus with high-grade dysplasia (HGD) and some benign diseases such as obstruction, end-stage achalasia, esophagus perforation or disruption, benign neoplasm, and severe caustic injury. For these patients, esophagectomy could relieve their symptom obviously. However, esophagectomy causes huge trauma, induces quite high morbidity and mortality, and may decreases patients' quality of life obviously due to postoperative reflux, dumping, anastomotic stricture and other complications. Accordingly, the considerations of a surgery must be carefully deliberated, including the underlying disorder, lesions localization, extent of disease, and options for esophageal replacement. For patients received esophagectomy and alimentary tract reconstruction, gastric conduit is the most common used replacement organ, then colon and jejunum. This review demonstrated the importance and technical experience of esophagectomy with gastric conduit reconstruction for benign diseases.

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Section: Factors Leading To Esophageal Failure In Benign Diseasementioning

confidence: 99%

Esophagectomy with gastric conduit reconstruction for benign disease: extreme but important

Guo

Yang

2018

Ann. Transl. Med.

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“…In this study, we provided the rst evidence that BLM caused gastrointestinal brosis, demonstrated both histologically and functionally. The gastrointestinal lesions of SSc patients included esophageal dysmotility, lower esophageal sphincter insu ciency, gastroesophageal re ux, esophageal stricture, a reduction in motility in the intestine, wide-mouthed diverticula in the large intestine and rectal atonia in advanced cases [15]. BLM-induced gastrointestinal lesions resembled several patterns of gastrointestinal lesions observed in SSc patients.…”

Section: Discussionmentioning

confidence: 72%

Soluble Guanylate Cyclase Reduced the Gastrointestinal Fibrosis in Bleomycin-induced Mouse Model of Systemic Sclerosis.

Yamamoto

Okano

Yamada

et al. 2021

Preprint

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Background: Systemic sclerosis (SSc) is a chronic autoimmune-mediated connective tissue disorder. Although the etiology of the disease remains undermined, SSc is characterized by fibrosis and proliferative vascular lesions of the skin and internal organs. SSc involves the gastrointestinal tract in more than 90% of patients. Soluble guanylate cyclase (sGC) is used to treat pulmonary artery hypertension (PAH), and has been shown to inhibit experimental skin fibrosis.Methods: Female C57BL/6J mice were treated with BLM or normal saline by subcutaneous implantation of osmotic minipump. These mice were sacrificed on day 28 or day 42. Gastrointestinal pathologies were examined by Masson Trichrome staining. The expression of fibrosis-related genes in gastrointestinal tract were analyzed by real-time PCR, and the levels of collagen in the tissue was measured by Sircol collagen assay. To evaluate peristaltic movement, the small intestinal transport (ITR%) was calculated as [Dyeing distance×(Duodenum- Appendix)] -1 ×100 (%). We treated BLM-treated mice with soluble guanylate cyclase (sGC) or DMSO orally and analyzed them on day 42.Results: Histological examination revealed that fibrosis from lamina propria to muscularis mucosa in the esophagus was significantly increased in BLM-treated mice, suggesting that BLM induces esophageal fibrosis in C57BL/6J mice. In addition, the levels of Col3a1 and CTGF were significantly increased in BLM-treated mice. More severe fibrosis was observed in the mice sacrificed on day 42 than the mice sacrificed on day 28. The ITR% was found to be significantly lower in BLM-treated mice, suggesting that gastrointestinal peristaltic movement was reduced in BLM-treated mice. Furthermore, we demonstrated that sGC treatment significantly reduced fibrosis of esophagus and intestine in BLM-treated mice, by histological examination and Sircol collagen assay. Conclusions: These findings suggest that BLM induces gastrointestinal fibrosis in C57BL/6J mice, and treatment with sGC improves the BLM-induced gastrointestinal lesion.

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“…In this study, we provided the first evidence that BLM caused gastrointestinal hyperproliferative and prefibrotic response, demonstrated both histologically and functionally. The gastrointestinal lesions of SSc patients included esophageal dysmotility, lower esophageal sphincter insufficiency, gastroesophageal reflux, esophageal stricture, a reduction in motility in the intestine, wide-mouthed diverticula in the large intestine, and rectal atonia in advanced cases [17]. BLM-induced gastrointestinal lesions resembled several patterns of gastrointestinal lesions observed in SSc patients.…”

Section: Discussionmentioning

confidence: 76%

Soluble guanylate cyclase stimulator reduced the gastrointestinal fibrosis in bleomycin-induced mouse model of systemic sclerosis

et al. 2021

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Background Systemic sclerosis (SSc) is a chronic autoimmune-mediated connective tissue disorder. Although the etiology of the disease remains undetermined, SSc is characterized by fibrosis and proliferative vascular lesions of the skin and internal organs. SSc involves the gastrointestinal tract in more than 90 % of patients. Soluble guanylate cyclase (sGC) stimulator is used to treat pulmonary artery hypertension (PAH) and has been shown to inhibit experimental skin fibrosis. Methods Female C57BL/6J mice were treated with BLM or normal saline by subcutaneous implantation of osmotic minipump. These mice were sacrificed on day 28 or day 42. Gastrointestinal pathologies were examined by Masson Trichrome staining. The expression of fibrosis-related genes in gastrointestinal tract was analyzed by real-time PCR, and the levels of collagen in the tissue were measured by Sircol collagen assay. To evaluate peristaltic movement, the small intestinal transport (ITR%) was calculated as [dyeing distance × (duodenum − appendix)] − 1 × 100 (%). We treated BLM-treated mice with sGC stimulator or DMSO orally and analyzed them on day 42. Results Histological examination revealed that fibrosis from lamina propria to muscularis mucosa in the esophagus was significantly increased in BLM-treated mice, suggesting that BLM induces esophageal hyperproliferative and prefibrotic response in C57BL/6J mice. In addition, the gene expression levels of Col3a1, CCN2, MMP-2, MMP-9, TIMP-1, and TIMP-2 in the esophagus were significantly increased in BLM-treated mice. More severe hyperproliferative and prefibrotic response was observed in the mice sacrificed on day 42 than the mice sacrificed on day 28. The ITR% was found to be significantly lower in BLM-treated mice, suggesting that gastrointestinal peristaltic movement was reduced in BLM-treated mice. Furthermore, we demonstrated that sGC stimulator treatment significantly reduced hyperproliferative and prefibrotic response of esophagus and intestine in BLM-treated mice, by histological examination and Sircol collagen assay. Conclusions These findings suggest that BLM induces gastrointestinal hyperproliferative and prefibrotic response in C57BL/6J mice, and treatment with sGC stimulator improves the BLM-induced gastrointestinal lesion.

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Esophagectomy in Scleroderma: Report of a Case

Cited by 6 publications

References 21 publications

Esophagectomy with gastric conduit reconstruction for benign disease: extreme but important

Esophagectomy with gastric conduit reconstruction for benign disease: extreme but important

Soluble Guanylate Cyclase Reduced the Gastrointestinal Fibrosis in Bleomycin-induced Mouse Model of Systemic Sclerosis.

Soluble guanylate cyclase stimulator reduced the gastrointestinal fibrosis in bleomycin-induced mouse model of systemic sclerosis

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