Gastric bypass for XXXX : a series of 21 cases.

@entity1 @entity4501 @entity5 @entity358 @entity1763 @entity292 @entity3147 @entity1576
OBJECTIVE: @entity1 with @entity5 of the esophagus who develop an @entity4501 die within 1 month in dramatic conditions of @entity3147 and @entity1763 . We assessed the beneficial palliative effect of the Kirschner operation in the treatment of @entity4501 . METHODS: Between January 1980 and August 1995, 21 @entity1 among a continuous series of 847 with @entity5 of the esophagus developed an @entity4501 . Prior to surgery, 2 @entity1 had an esophageal prosthesis followed by radio- and/or radiochemotherapy and 6 had radio- and/or chemotherapy at curative doses. The Kirschner operation was carried out in all @entity1 with exclusion of the lower end of the esophagus using a Roux-en Y-loop (n = 19) or ligature (n = 2). RESULTS: Within 1 month of surgery, 8 @entity1 (38%) died. Median length of stay in the intensive care unit and hospitalization was 6 days (1-30) and 17 days (3-57), respectively. Among the 13 survivors, @entity358 (n = 2) and cervical fistulae (n = 5) complicated the postoperative period. Among the cervical @entity292 , 3 of them resolved favorably. Radio- and/or chemotherapy was given postoperatively in 7 @entity1 without any improvement in survival. Among the 13 @entity1 surviving beyond the postoperative period, median survival was 109 days; 7 were able to resume oral nutrition and quality of life was assessed as excellent in 6 of them. CONCLUSION: The Kirschner operation can provide a beneficial palliative effect in @entity1 with an @entity4501 despite the high risk of operative mortality. Ideally, the Kirschner should be carried out in young @entity1 who are still in good general health, before the development of @entity1576 compromises surgery.
