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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_1738_Библиотеки_им_академика_М_И_Перельмана.pdf
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- •Contents
- •Contributors
- •Right Thoracoscopic View
- •Left Thoracoscopic View
- •Laparoscopic View
- •Introduction
- •References
- •Anatomy of the Esophagus
- •Architecture of the Esophageal Wall
- •Blood Supply
- •Lymphatic Drainage
- •Innervation
- •Physiology
- •Upper Esophageal Sphincter
- •Esophageal Body
- •Lower Esophageal Sphincter
- •References
- •Introduction
- •Functional Constituents of the Esophagogastric Junction
- •Mechanisms of EGJ Incompetence in GERD
- •Transient Lower Esophageal Sphincter Relaxations
- •Lower Esophageal Sphincter Hypotension
- •The Diaphragmatic Sphincter and Hiatus Hernia
- •Gastroesophageal Flap Valve
- •Mechanical Properties of the Relaxed EGJ
- •Esophageal Acid Clearance
- •Summary
- •References
- •Introduction
- •Swallow Analysis
- •Evaluation of EGJ
- •EPT Metrics to Assess the Deglutitive Esophageal Contraction
- •Scoring Individual Swallows
- •Esophageal Motility Disorders
- •Future Applications for Postsurgical Conditions
- •Conclusion
- •References
- •Introduction
- •Symptomatic Evaluation
- •Barium Esophagram
- •Upper Endoscopy
- •Esophageal Manometry
- •Ambulatory 24-h pH Monitoring
- •Multichannel Intraluminal Impedance pH Monitoring
- •Radiolabeled Gastric Emptying Study
- •References
- •Preoperative Evaluation
- •Cardiac Evaluation
- •Electrocardiogram (ECG)
- •Hypertension
- •Angioplasty
- •Coronary Stents
- •Bare-Metal Stents
- •Drug-Eluting Stents
- •Pulmonary Evaluation
- •Chest X-Ray (CXR)
- •Pulmonary Function Tests (PFTs)
- •Smoking
- •Obstructive Sleep Apnea Syndrome (OSAS)
- •Pulmonary Aspiration
- •Nasogastric Tubes
- •Intraoperative Monitoring
- •One-Lung Ventilation (OLV)
- •Double-Lumen Endobronchial Tube (DLT)
- •Bronchial Blockers
- •Torque Control Blocker (Univent)
- •Surgery for Esophageal Diverticula
- •Surgery for Achalasia
- •Esophageal Perforation and Rupture
- •Tracheoesophageal Fistula (TEF)
- •Esophagogastroduodenoscopy
- •Esophageal Foreign Bodies
- •Scleroderma
- •GERD and End-Stage Lung Diseases (ESLD)
- •Esophagectomy
- •Fluid Therapy
- •Postoperative Management
- •Pain Management
- •References
- •Technique of Laparoscopic Repair of Epiphrenic Diverticula
- •Preparation
- •Port Placement
- •Mobilization of the Distal Esophagus
- •Exposure of the Diverticulum Neck
- •Stenting
- •Stapling
- •Esophageal Musculature Closure
- •Myotomy
- •Closure of the Esophageal Hiatus
- •Partial Fundoplication
- •Technique of Thoracic Repair
- •Preparation
- •Port Placement
- •Esophageal Mobilization
- •Outcomes
- •Conclusion
- •References
- •Introduction
- •Pathophysiology
- •Epidemiology and Clinical Manifestations
- •Dissection of the Diverticulum
- •Stenting the Esophagus
- •Diverticulectomy
- •Muscle Approximation
- •Myotomy
- •Laryngeal
- •Nasal
- •Otologic
- •Diagnosis
- •History
- •Endoscopy
- •Ambulatory pH and Impedance Monitoring
- •Treatment
- •Medical
- •Surgical
- •References
- •Introduction
- •Laparoscopic Total Fundoplication
- •Positioning of the Patient on the Operating Table
- •Instrumentation for Laparoscopic Fundoplication
- •Step 1: Placement of Trocars
- •Step 4: Division of Short Gastric Vessels
- •Step 6: Closure of Crura
- •Laparoscopic Partial Fundoplication
- •Partial Posterior Fundoplication
- •Partial Anterior Fundoplication
- •Postoperative Course
- •Postoperative Complications
- •Short-Term Outcomes
- •Long-Term Outcomes
- •References
- •Introduction
- •Asthma
- •Prevalence and Pathophysiology
- •Symptoms and Diagnosis
- •Treatment
- •Prevalence and Pathophysiology
- •Symptoms and Diagnosis
- •Treatment
- •Bronchiolitis Obliterans Syndrome
- •Diagnosis and Treatment
- •Obesity
- •Prevalence and Pathophysiology
- •Treatment
- •References
- •Introduction
- •Endoscopic Suturing and Plicators
- •Injections and Implants
- •Radiofrequency Ablation
- •Technique
- •Conclusions
- •References
- •Introduction
- •Pathophysiology
- •Clinical Presentation
- •Diagnosis
- •Endoscopic Management
- •Endoscopic Injection of Botulinum Toxin
- •Pneumatic Dilation
- •Per-oral Endoscopic Myotomy (POEM)
- •Posttreatment Follow-Up
- •Timed Barium Esophagram
- •Manometry
- •Posttreatment GERD
- •Conclusion
- •References
- •Introduction
- •Patient’s Positioning
- •Placement of Ports
- •Dissection
- •Division of the Short Gastric Vessels
- •Myotomy
- •Partial Anterior Fundoplication
- •Postoperative Complications
- •References
- •Presenting Symptoms
- •Indications for Surgery
- •Preoperative Evaluation
- •Operative Technique
- •Patient Positioning and Setup
- •Trocar Placement
- •Dissection and Reduction of the Hernia Sac
- •Esophageal Mobilization and Lengthening
- •Crural Closure and Options for Mesh Reinforcement
- •Fundoplication
- •Postoperative Care
- •Conclusion
- •References
- •Introduction
- •General Considerations
- •Clinical Manifestations
- •Investigation
- •Management
- •Preoperative Evaluation
- •Minimally Invasive Surgery
- •Endoscopic Surgery
- •Robotic Surgery
- •Management According to Tumor Type
- •Intramural-Extramucosal Tumors
- •Leiomyoma
- •Clinical Features
- •Indications for Tumor Removal
- •Treatment
- •Granular Cell Tumor
- •Clinical Features
- •Indications for Tumor Removal
- •Treatment
- •Hemangioma
- •Clinical Features
- •Indications for Tumor Removal
- •Treatment
- •Lipoma
- •Clinical Features
- •Indication for Tumor Removal
- •Treatment
- •Intraluminal-Mucosal Tumors
- •Fibrovascular Polyp
- •Clinical Features
- •Indications for Tumor Removal
- •Treatment
- •Cysts and Duplications
- •Clinical Features
- •Indications for Tumor Removal
- •Treatment
- •Technical Considerations During Minimally Invasive Surgery
- •Thoracoscopic Enucleation
- •Laparoscopic Enucleation
- •Minimally Invasive Gastroesophageal Resection
- •Outcomes and Complications
- •Conclusions
- •References
- •Introduction
- •Treatment of GERD
- •Endoscopic Dysplasia Surveillance
- •Endoscopic Evaluation
- •Procedure Overview
- •Endoscopic Assessment
- •Endoscopic Ultrasound (EUS)
- •Endotherapy
- •Resection
- •Ablation
- •Adjunctive Techniques
- •Hybrid Approaches
- •Indications for Esophagectomy
- •Intense Surveillance
- •Conclusion
- •References
- •Introduction
- •Indications
- •Patient’s Preparation
- •Operative Techniques
- •Strategies for Avoiding and Managing Complications
- •Quality of Life After Esophagectomy
- •References
- •Persistent Dysphagia
- •Recurrent Dysphagia
- •Diagnostic Evaluation
- •Treatment
- •Pneumatic Balloon Dilatation
- •Revisional Surgery
- •Esophagectomy
- •Alternative Treatment Modalities
- •Conclusions
- •References
- •Persistent or Recurrent Symptoms: Why?
- •Wrong Indications
- •Wrong Preoperative Work-Up
- •Failure to Execute the Proper Technical Steps
- •Clinical Presentation and Evaluation
- •Symptomatic Evaluation
- •Barium Swallow and Endoscopy
- •Esophageal Manometry
- •Ambulatory pH Monitoring
- •Causes of Failure
- •Type IA Hernia
- •Type II Hernia
- •Type III Hernia
- •Management
- •Outcome
- •References
- •Index

Surgical Management
of Benign Esophageal
Disorders
P. Marco Fisichella
Nathaniel J. Soper
Carlos A. Pellegrini
Marco G. Patti
Editors
123
The “Chicago Approach”

Surgical Management of Benign
Esophageal Disorders


P. Marco Fisichella • Nathaniel J. Soper
Carlos A. Pellegrini • Marco G. Patti
Editors
Surgical Management
of Benign Esophageal
Disorders
The “Chicago Approach”

ISBN 978-1-4471-5483-9 ISBN 978-1-4471-5484-6 (eBook)
DOI 10.1007/978-1-4471-5484-6
Springer London Heidelberg New York Dordrecht
Library of Congress Control Number: 2013950717
© Springer-Verlag London 2014
This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part
of the material is concerned, specifi cally the rights of translation, reprinting, reuse of illustrations,
recitation, broadcasting, reproduction on microfi lms or in any other physical way, and transmission or
information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar
methodology now known or hereafter developed. Exempted from this legal reservation are brief excerpts
in connection with reviews or scholarly analysis or material supplied specifi cally for the purpose of being
entered and executed on a computer system, for exclusive use by the purchaser of the work. Duplication
of this publication or parts thereof is permitted only under the provisions of the Copyright Law of the
Publisher's location, in its current version, and permission for use must always be obtained from Springer.
Permissions for use may be obtained through RightsLink at the Copyright Clearance Center. Violations
are liable to prosecution under the respective Copyright Law.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication
does not imply, even in the absence of a specifi c statement, that such names are exempt from the relevant
protective laws and regulations and therefore free for general use.
While the advice and information in this book are believed to be true and accurate at the date
of publication, neither the authors nor the editors nor the publisher can accept any legal responsibility
for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with
respect to the material contained herein.
Printed on acid-free paper
Springer is part of Springer Science+Business Media (www.springer.com)
Editors
P. Marco Fisichella, MD, MBA, FACS
Department of Surgery
Stritch School of Medicine
Loyola University Medical Center
Maywood , IL
USA
Nathaniel J. Soper, MD, FACS
Department of Surgery
Northwestern University
Feinberg School of Medicine
Chicago , IL
USA
Carlos A. Pellegrini, MD
Department of Surgery
University of Washington
School of Medicine
Seattle , WA
USA
Marco G. Patti, MD
Department of Surgery
Center for Esophageal Diseases
University of Chicago
Pritzker School of Medicine
Chicago , IL
USA

This book is dedicated to our medical
students, residents, and fellows who give
meaning to our work


Contents
1 Esophageal Anatomy and Physiology for the Surgeon . . . . . . . . . . . . 1
Marco E. Allaix and Marco G. Patti
2 Pathophysiology of Gastroesophageal Refl ux Disease . . . . . . . . . . . . . 11
Peter J. Kahrilas and John E. Pandolfi no
3 The Chicago Classifi cation of Esophageal Motility Disorders . . . . . . 25
Peter J. Kahrilas, Sabine Roman, and John E. Pandolfi no
4 Gastroesophageal Refl ux Disease: Preoperative Evaluation . . . . . . . . 39
Marco E. Allaix, Fernando A. Herbella, and Marco G. Patti
5 Surgery for Esophageal Disorders: The Anesthesiologist’s View . . . . 49
Barbara G. Jericho
6 Treatment of Epiphrenic Diverticula . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Anahita Jalilvand, P. Marco Fisichella, Pitichote Hiranyatheb,
and Mark K. Ferguson
7 Head and Neck Manifestations of Gastroesophageal
Refl ux Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
David D. Walker and Alexander J. Langerman
8 Minimally Invasive Treatment of GERD . . . . . . . . . . . . . . . . . . . . . . . 101
Marco E. Allaix, Fernando A. Herbella, and Marco G. Patti
9 Minimally Invasive Treatment of GERD: Special Situations . . . . . . . 113
Yee M. Wong and P. Marco Fisichella
10 Endoscopic Treatment of Gastroesophageal Refl ux Disease . . . . . . . . 129
Marie C. Ziesat and Michael B. Ujiki
11 Endoscopic Management of Achalasia . . . . . . . . . . . . . . . . . . . . . . . . . 141
Eric S. Hungness and Peter J. Kahrilas
vii

viii
12 Surgical Treatment of Esophageal Achalasia . . . . . . . . . . . . . . . . . . . . 155
Marco E. Allaix, Adrian Dobrowolsky, and Marco G. Patti
13 Paraesophageal Hernias: Indications
and Surgical Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165
Ezra N. Teitelbaum and Nathaniel J. Soper
14 Minimally Invasive Treatment of Benign
Esophageal Tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 181
Pitichote Hiranyatheb and Mark K. Ferguson
15 Barrett’s Esophagus: Treatment Options
and Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201
Wesley D. Leung and Irving Waxman
16 Surgery for Barrett’s Esophagus: From Metaplasia
to Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 215
Ellen H. Morrow and Brant K. Oelschlager
17 Revisional Surgery for Achalasia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 227
Elizabeth A. Warner, Marco G. Patti, Marco E. Allaix,
and Carlos A. Pellegrini
18 Failed Antirefl ux Surgery: Analysis
of the Causes and Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 241
Marco E. Allaix, Fernando A. Herbella, and Marco G. Patti
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 251
Contents

Contributors
Marco E. Allaix , MD Department of Surgery, Center for Esophageal Diseases ,
Pritzker School of Medicine, University of Chicago , Chicago , IL , USA
Adrian Dobrowolsky , MD Department of Surgery, Stritch School of Medicine ,
Loyola University Medical Center , Maywood , IL , USA
Mark K. Ferguson , MD Department of Surgery , The University of Chicago ,
Chicago , IL , USA
P. Marco Fisichella , MD, MBA, FACS Department of Surgery, Stritch School of
Medicine , Loyola University Medical Center , Maywood , IL , USA
Fernando A. Herbella , MD Department of Surgery, Center for Esophageal
Diseases , Pritzker School of Medicine, University of Chicago , Chicago , IL , USA
Pitichote Hiranyatheb , MD Department of Surgery , The University of Chicago ,
Chicago , IL , USA
Eric S. Hungness , MD Department of Surgery, Feinberg School of Medicine ,
Northwestern University , Chicago , IL , USA
Anahita Jalilvand , MD Department of Surgery, Loyola Stritch School
of Medicine , Loyola UniversityMedical Center , Maywood , IL , USA
Barbara G. Jericho , MD Department of Anesthesiology , The University
of Illinois Hospital and Health Sciences System , Chicago , IL , USA
Peter J. Kahrilas , MD Division of Gastroenterology, Department of Medicine ,
Feinberg School of Medicine, Northwestern University , Chicago , IL , USA
Center for Esophageal Disease, Department of Medicine, Feinberg School
of Medicine, Northwestern University , Chicago , IL , USA
Alexander J. Langerman , MD Section of Otolaryngology – Head and Neck
Surgery , University of Chicago Medical Center , Chicago , IL , USA
ix
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