Postoperative Imaging of Esophageal Cancer: What Chest Radiologists Need to Know

Kim, Tae Jung; Lee, Kyung Ho; Kim, Young Hoon; Sung, Sook Whan; Jheon, Sanghoon; Cho, Sukki; Lee, Kyungwon

doi:10.1148/rg.272065034

Cited by 46 publications

(14 citation statements)

References 66 publications

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“…Left Thoracoabdominal Approach.-The left thoracoabdominal approach is used primarily for distal esophageal and gastroesophageal junction tumors and provides exposure of the superior abdominal and posterior mediastinal compartments through a single incision (6). Extensive lymphadenectomy can be performed in the abdomen and posterior mediastinum with this technique (13). However, thoracoabdominal incisions may be poorly tolerated by patients and may result in substantial debility.…”

Section: Teaching Pointsmentioning

confidence: 99%

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Esophagectomy and Gastric Pull-through Procedures: Surgical Techniques, Imaging Features, and Potential Complications

Flanagan¹,

Batz²,

Saboo³

et al. 2016

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Esophagectomy takes the center stage in the curative treatment of local and local-regional esophageal cancer. It is a complex procedure with a high postoperative complication rate. When interpreting imaging studies, radiologists must understand the surgical techniques used and their potential complications. The most common surgical techniques are transthoracic esophagectomies, such as the Ivor Lewis and McKeown techniques, and transhiatal esophagectomy. Variations of these techniques include different choices of conduit (ie, stomach, colon, or jejunum) to serve in lieu of the resected esophagus. Postoperative imaging and accurate interpretation is vital in the aftercare of these patients. Chest radiographs, esophagrams, and computed tomographic images play an essential role in early identification of complications. Pulmonary complications and anastomotic leaks are the leading causes of postoperative morbidity and mortality secondary to esophagectomy. Other complications include technical and functional problems and delayed complications such as anastomotic strictures and disease recurrence. An esophagographic technique is described that is performed by using hand injection of contrast material into an indwelling nasogastric tube. Familiarity with the various types of esophagectomy and an understanding of possible complications are of utmost importance for radiologists and allow them to be key participants in the treatment of patients undergoing these complicated procedures.

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Section: Teaching Pointsmentioning

confidence: 99%

“…Disadvantages of using the colon as an interposition include a technically demanding procedure performed, and the esophagus is removed via the abdominal incision. The gastric conduit is then brought up to the neck through the posterior mediastinum to create a cervical esophagogastric anastomosis (Fig 3c-3e) (13).…”

Section: Transhiatal Esophagectomymentioning

confidence: 99%

Esophagectomy and Gastric Pull-through Procedures: Surgical Techniques, Imaging Features, and Potential Complications

Flanagan¹,

Batz²,

Saboo³

et al. 2016

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“…To translate these findings into clinical practice, patients with low CPNE5 expression ought to undergo surgery with rigorous lymph node dissection (33) and adequate surgical margins (34). Frequent follow-up, including esophagoscopy (35) and computed tomography (36), may enhance the detection of local recurrence.…”

Section: Discussionmentioning

confidence: 99%

Copine�5 expression predicts prognosis following curative resection of esophageal squamous cell carcinoma

et al. 2018

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Patients with esophageal squamous cell carcinoma (ESCC) have a poor prognosis. Identification of biomarkers to accurately predict the risk of recurrence and survival following curative esophageal resection is required to improve patient outcomes. The copine 5 (CPNE5) gene encodes a calcium-dependent lipid-binding intracellular protein. Copine proteins interact with diverse target proteins that are components of pathways that aberrantly regulate the phenotypes of malignant cells. However, limited information is available on the role of CPNE5 in cancer. The present study investigated whether CPNE5 may serve as a predictive marker of the prognosis of patients with ESCC following curative resection. CPNE5 mRNA expression levels and the methylation status of the CPNE5 promotor region were measured in 11 ESCC cell lines. CPNE5 mRNA expression levels in 106 pairs of surgically resected specimens were measured, and their associations with clinicopathological characteristics were analyzed. The CPNE5 mRNA expression levels in 9 ESCC cell lines were decreased compared with those of the non-tumorigenic esophageal mucosa cell line Het-1A. Bisulfite sequencing detected the methylation of the CPNE5 promotor region in all cell lines tested, including Het-1A. Furthermore, analysis of tissues revealed that CPNE5 mRNA expression was significantly lower in ESCC cells compared with cognate non-cancerous adjacent mucosal cells. Kaplan-Meier analysis revealed that patients with low CPNE5 expression experienced significantly shorter overall survival. Multivariable analysis identified low CPNE5 expression to be an independent prognostic factor of OS. Analysis of recurrence patterns revealed that significantly more patients with local recurrence expressed lower levels of CPNE5 mRNA. These findings indicated that CPNE5 expression in ESCC tissues may serve as an informative biomarker for predicting ESCC recurrence, particularly in patients with local recurrence, and may help to ensure that patients receive optimal treatment and follow-up.

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“…Ova metoda povrðuje postojanje dehiscencije anastomoze ali ne omoguaeava preciznije definisanje njenih karakteristika. Kompjuterizovana tomografija (CT) vrata, grudnog koša i po potrebi gornjeg abdomena može pružiti informacije o mestu dehiscencije, kao i o postojanju perianastomotskih teènih kolekcija, medijastinitisa i pleuralnog izliva (empijem) 46 . Koristi se i CT-om voðena perkutana punkcija i drenaža perianastomotskih teènih kolekcija 33,43 .…”

Section: Anastomotske Komplikacije Nakon Ezofagealne Rekonstrukcijeunclassified

Perioperative complications of esophagectomy - prevention, diagnosis and management

Stojakov¹,

Sabljak²,

Spica³

et al. 2017

ACTA CHIR IUG

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Ezofagealna resekcija sa rekonstrukcijom predstavlja složenu hiruršku proceduru koja je još uvek praaeena visokim postoperativnim morbiditetom, ali je mortalitet poslednjih decenija u stalnom padu, posebno u ustanovama sa velikim iskustvom. Brojni preoperativni, intraoperativni i postoperativni faktori utièu na uèestalost i vrstu perioperativnih komplikacija. Intraoperativno krvarenje i lezija traheobronhijalnog stabla mogu se izbeaei dobrom hirurškom procenom i operativnom tehnikom. Pluaene komplikacije su èeste, uzroci njihovog nastanka multifaktorijalni, i najèešaei su uzrok postoperativnog mortaliteta nakon ezofagektomije. Dehiscencija ezofagealne anastomoze može imati fatalne posledice, zahteva što ranije postavljanje dijagnoze i dobru procenu. U veaeini sluèajeva ova komplikacija se može uspešno konzervativno tretirati, a reoperacija je neophodna u sluèaju nekroze ezofagealnog substituenta. Paraliza/pareza glasnica uzrokovana intraoperativnom lezijom povratnih laringealnih nerava nije retka i znatno poveaeava uèestalost pluaenih komplikacija. Novonastala srèana aritmija može ukazati na razvoj drugih postoperativnih komplikacija. Postezofagektomijski hilotoraks može dovesti do brzog razvoja imunosupresije i septiènih komplikacija, te je èesto neophodna rana ligatura torakalnog duktusa. Intratorakalna hernijacija abdominalnih organa je retka, a ishemijska lezija kièmene moždine je izuzetno retka komplikacija ezofagektomije. Mnoge od navedenih komplikacija se mogu prevenirati, ili uspešno sanirati, što dovodi do znatnog smanjenja mortaliteta ezofagektomije. Kljuène reèi: Ezofagektomija, perioperativne / postoperativne komplikacije, anastomotske komplikacije, respiratorne komplikacije, dehiscencija anastomoze, hilotoraks UVOD E zofagealna resekcija sa rekonstrukcijom predstavlja

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Postoperative Imaging of Esophageal Cancer: What Chest Radiologists Need to Know

Cited by 46 publications

References 66 publications

Esophagectomy and Gastric Pull-through Procedures: Surgical Techniques, Imaging Features, and Potential Complications

Esophagectomy and Gastric Pull-through Procedures: Surgical Techniques, Imaging Features, and Potential Complications

Copine�5 expression predicts prognosis following curative resection of esophageal squamous cell carcinoma

Perioperative complications of esophagectomy - prevention, diagnosis and management

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