Doctor insights on:
Post Esophagectomy Complications
The esophagus carries food and liquid from the mouth to the stomach. Any word ending with the suffix "-ectomy" means removal, as in appendectomy, tonsillectomy, etc. Esophagectomy is usually reserved for patients with esophageal cancer, but may rarely be used for other benign forms of obstruction. The stomach can be mobilized and pulled up into the chest ...Read more
Removal of esophagus: The esophagus carries food and liquid from the mouth to the stomach. Any word ending with the suffix "-ectomy" means removal, as in appendectomy, tonsillectomy, etc. Esophagectomy is usually reserved for patients with esophageal cancer, but may rarely be used for other benign forms of obstruction. The stomach can be mobilized and pulled up into the chest to replace the esophagus. ...Read more
Thoracic surgeons: The society of thoracic surgeons does, in fact, have a list: http://www. Sts. Org/membership/membership-directory. Additionally, you can contact your state's closest medical school, ask to be directed to the department of thoracic surgery, and ask for a referral near where you live. Good luck and be well. ...Read more
Possibly...: Dumping syndrome implies bolus emptying of the stomach into the duodenum with associated release of digestive hormones & insulin. The esophagus does not play a role in this syndrome. But if you have had a gastric pull-up procedure (where the stomach is now in your chest to take the place of the removed esophagus, undoubtedly its motility has been altered & as such dumping syndrome may be modified. ...Read more
Expertise: Esophagectomy or removal of the esophagus for cancer is a difficult operation. However, the surgeons who have good outcomes are the ones who expertise with the procedure. Things to look out for: do they do more than 12-15 esophagectomies per year? To they have a post-op care pathway? Are their nurses skilled in the care of the esophagectomy patient? Do they have a plan for when you go home? And do they explain things to you and your family clearly? ...Read more
Multiple options: The pain is likely to be because of the incision, caused by injury or pressure on an intercostal nerve, which runs under each rib. This can resolve over time, or will take medication or some other form of intervention to heal. The last resort would be an intercostal nerve ablation, which renders the area numb. ...Read more
Can you tell me about an esophagectomy because of high grade dysplasia and how is quality of life after it?
Not bad: Make significant number of patients with HGD have cancer when the resected esophgus is examined pathologically. Resection is the gold standard for treatment and 5 year survival approaches 100%. Quality of life is influenced by the resection technique and skill/experience of the surgeon. Choose a center that has extensive experience and good outcomes. ...Read more
Can you tell me about surgical procedure for esophagectomy. What skin prep and meds are used during surgery?
Ivor Lewis procedure: Esophagectomy is usually performed for lesions of lower esophagus and require esophagogastrectomy usually performed thoracoabdominally. Thru abdomen and right chest. A transesphageal ultra sound is performed to define penetration of mucosal tumor into muscularis and nodes. Pre op RT and chemo are essential to get best chance for cure. ...Read more
What do you suggest if my husband had an esophagectomy. A very long surgery. He was intubated for two days. Now his epiglottis wont?
Patience: The vocal cords and epiglottis have been irritated by the tube used while he was intubated. This should clear up after 2-10 days. Seldom is there any permanent damage. If problems persist, a visualization of the cords is a relatively easy procedure. ...Read more
Can be serious: Esophageal problems causing dysphagia are usually related to strictures. Depending on where the problem arises, various procedures to relieve the blockage are available. This includes laser reopening, various forms of dilatation or a plasty type of procedure to widen the stricture site. Removal of the esophagus is usually relegated to carcinoma of the esophagus and is a large procedure. ...Read more
I had Esophagectomy, stage 3 cancer 1 year ago. Check-up showed a cloudiness in the lower half of lobe of lung. Said will check in 6 months! Safe???
I had a total Esophagectomy 4 years ago due to acid reflux. I still have acid reflux to this day even worse. Can I get throat cancer from the reflux?
Very unlikely: If the entire esophagus was removed, the chances of getting Barretts esophagus from the continued reflux is very unlikely. Having said that, if you are still having symptoms, it bears periodic evaluation to see how severe the inflammation is. You also should be treating the reflux to keep the symptoms under control. Good luck. ...Read more
Timing: Timing of swallowing liquids with regards of performance of gastric tube anastomosis is important. Enough time is allowed for anastomotic healing before trying to swallow any food or liquid. Depending on how good the gastric tube drainage is you may be able to swallow easy. The wound healing process is similar for all wounds. By 21 days wounds develop 1/3 of base tensile strenght. ...Read more
Currently being considered for coblation nucleoplasty trial (cervical). Contained herniation. I'm in early 20's. Possible long term complications?
Coblation: Understand, these treatments are low (not zero) risk, but for what purpose? Contained herniation means that there is no pressure on the nerves, and the disc is simply not in a "normal" location within the disc space. Study? Fine. These haven't worked except temporarily in the lumbar spine. I would be pessimistic. Maximize mckenzie pt. Not heat/us/tens as they are useless. If no other option, fine. ...Read more
Organ damage: GD is treatable if diagnosed early and enzyme replacement started. Specific enzyme deficiency cause organs damage due to abnormal accumulation of unrecycled compounds called glycolipids. The spleen, liver, bones, bone marrow, skin, lungs and growth/dev, and in some subclass of GD, the CNS are affected. Increased risk of malignancy. Manifestations and severity vary. Consult with a geneticist pls. ...Read more
Vomit/Diarrhea: Usually food borne illnesses cause vomiting or diarrhea, but it really depends on the infection type. Food borne illnesses can be caused by bacteria, parasites, some viruses, and toxins produced by bacteria and molds. The symptoms will be a little different with each one. Some ca be deadly other just unpleasant. ...Read more
Allergic conjunctivitis due to environmental allergies like dander or pollen generally causes symptoms but no serious consequences. However, there is a condition called keratoconjunctivitis which can cause some damage. This is not commonly seen in typical allergic conjunctivitis.
Another unusual situation is vernal conjunctivitis. I suspect the answer is nothing. ...Read more
Injury: The worst complications with an iud deal with injury and/or infection. Uterine injury (perforation) at insertion can lead to bleeding, pain, or intra-abdominal placement. Infections can occur which can lead to scarring or abcess formation. More common are iud expulsions which can go unnoticed & lead to unintended pregnancy. Overall, they are very safe & provide excellent birth control. Take care. ...Read more
Yes: Prenatal diagnosis of fetal conditions has both pros and cons - one con is that prenatal diagnosis is never 100% and can cause undue stress on parents during the remainder of the gestation. A desire to obtain prenatal diagnosis should only be done after careful thought about how you & your significant other will respond to the news and what you will do with the information. ...Read more
MicroAlb/Cr ratio: Is commonly obtained in diabetics to assess for end-organ involvement. 30.79 is borderline high. It could be indicative of end-organ damage to the kidneys, but could also be a false positive depending on the setting urine specimen was obtained. It should be measured once more in a few months to help better understand its prognostic significance. No need to perform this test in healthy individuals. ...Read more
Yes: Serious complications of vsd repair are very uncommon. They include bleeding, infection, and brain injury. There is also a small risk of damage to the conduction system of the heart that would require a permanent pacemaker. The risk of dying from the procedure is exceedingly low, but not zero. ...Read more
Kids are tougher!: Pain in children seems to be less intense than in adults--perhaps one of the reasons I am a pediatrician! Children's tonsils generally have less scarring, making the removal less tedious. Also, the blood supply and healing tendency in children can be more responsive. But mostly, a child's tonsils tend to be smaller than adult tonsils--hence less scarring= less complication. ...Read more
Uterine Rupture: The most common complications are a failed vbac & need for vaginal bypass (c-section). The most serious are uterine dehiscence (separation of the uterine scar) or rupture. This can lead to catastrophic results with hemorrhage, emergency surgery, hysterectomy, and fetal loss. Major point - please vbac in a hospital where your OB can keep you safe and have access to immediate surgery if needed. ...Read more
Short and long term: There are both short and long term complications of tpn. Short term complications include infections, and imbalance of electrolytes, fluid status and blood glucose levels. Long term TPN can result in loss of IV access and also liver injury and cirrhosis. If you remain on TPN for more than 2-3 months, you should be evaluated at an intestine failure center which may consider intestine transplant. ...Read more
Discuss w/ Retina MD: The most common complication from a vitrectomy is progression of cataract. At your age of 40, that may not be a major factor. Other risks that occur less than 5% of the time are retinal detachment, and bleeding. Post-operative infections from vitrectomies are rare. Depending on what the underlying condition is that you have, there may be a risk of disease progression and need for further surgery. ...Read more
ESR is a marker of: Erythrocyte sedimentation rate (ESR) is a marker of inflammation, thus high inflammatory processes cause ESR to be higher. Infections, cancers, uncontrolled rheumatologic diseases, and endovascular inflammation (i.e. Arteritis) are examples. Thus, elevated ESR values suggest inflammatory conditions which should be sought and treated. Esr is not a complication, but a marker! Consult doc. Good luck. ...Read more