By Izbicki J.R. (ed.), Chernousov A.F. (ed.), Broering D. (ed.)
This atlas presents an intensive review on present surgical options within the therapy of esophageal ailments. the 1st a part of this atlas is targeted on simple diagnostic instruments, symptoms and preoperative paintings up. the second one half indicates profound directions for present surgeries illustrated with specified drawings intimately and operation observe variety textual content to let the training health practitioner in addition to the skilled health professional to accomplish even the main complicated operations. the fundamental ideas of esophageal surgical procedure in addition to traditional surgical procedure, endoscopic and minimum invasive ideas are vividly awarded in accordance with the advances accomplished in esophageal surgical procedure. This atlas comprises: easy rules in esophageal surgical procedure, surgical recommendations together with endoscopic and minimum invasive methods, certain drawings with operation word kind textual content and precise anatomic and surgical wisdom, in actual fact outlined suggestions to let the doctor to accomplish even the main advanced op's.
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Extra info for Surgery of the Esophagus: Textbook and Atlas of Surgical Practice
Example text
Of 60 patients with esophageal cancer who underwent pre-operative CT and EUS, sensitivities for T and N staging were 58% and 79% for CT and 72% and 91% for EUS, respectively (Figs. 7). Specificity for both T and N stages was 80% and 84% for CT and 85% and 68% for EUS, respectively [28]. The impact of the tumor stage on final therapy was assessed in 125 patients. CT was less accurate (51%) than EUS (74%) for nodal staging. EUS-FNA further improved these results [29]. In recent years Positron Emission Tomography (PET), a new imaging technique, has been introduced to overcome some of the shortcomings of CT for staging.
Hünerbein M, Ghadimi BM, Hänsch W et al (1998) Transendoscopic ultrasound of esophageal and gastric cancer using miniaturized ultrasound catheter probes. Gastrointest Endosc 48:371–375 40. Chak A, Canto M, Stevens PD et al (1997) Clinical applications of a new through the scope ultrasound probe. Prospective comparison with an ultrasound endoscope. Gastrointest Endosc 45:291– 295 41. Isenberg G, Chak A, Canto MI et al (1998) Endoscopic ultrasound in restaging of esophageal cancer after neoadjuvant chemoradiation.
Consequently in addition to T-staging it is possible to stage local nodes larger than 3–5 mm (Nstaging) [9, 10] as well as some distant metastatic nodes (M-staging), in particular celiac axis nodes. Assessment of these distant nodes is most important if primary surgery with curative intent has been planned. Tytgat and Tio [11] attempted to define EUS criteria for “normal” and “metastatic” lymph nodes in the presence of malignant disease. Criteria such as size, echogenicity, round shape, and smooth borders were used to classify nodes.
