Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
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Gastroesophageal reflux disease (GERD) in lung transplant recipients has gained increasing attention as a factor in allograft failure. There are few data on the impact of fundoplication on survival or lung function, and less on its effect on symptoms or quality of life. Patients undergoing fundoplication following lung transplantation from 1999 to 2005 were included in the study. ⋯ It may, however, slow progression to the more advanced stages of BOS. Reflux symptoms are well controlled and patients are highly satisfied. Whether performing fundoplication early post-lung transplant in selected patients can prevent BOS and improve long-term outcomes requires formal evaluation.
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Greater than 50% of patients with esophageal carcinoma are found to be incurable at the time of diagnosis, leaving only palliative options. Self-expanding metal stents (SEMs) are effective for relieving symptoms and complications associated with esophageal carcinoma and improving quality of life. We undertook a retrospective analysis to evaluate the experience of palliative esophageal stenting for symptomatic malignant dysphagia in our institution over a period of 7 years. ⋯ There is no significant difference in complications or survival when using endoscopic or radiologic methods to deploy SEMs in patients with inoperable esophageal cancer. Mortality is low; however, the morbidity rate is significant. Patients receiving adjuvant chemotherapy or radiotherapy, in addition to stenting, survived significantly longer than those with a stent only.
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The number of esophageal mucosa mast cells (MCs) increases in allergic and inflammation conditions in the esophagus, but their role in these conditions is less clear. MCs are derived from bone marrow, migrate and mature in the peripheral tissues. Two subsets of MCs have been characterized as mucosal MC (MMC) and connective tissue MC (CTMC) defined by anatomic location, granule contents, and functions. ⋯ OVA in vitro challenge of the esophagus from sensitized guinea pig significantly decreased tryptase-positive MC subtypes MCtc and MCt, and released a significant amount of tissue histamine content. In conclusion, MCs in the guinea pig esophagus have unique features in immunophenotypes, distribution, and degranulation response to OVA challenge with the release of significant amounts of proteases and histamine into the tissue. These characteristics may indicate that OVA in vitro challenge in OVA-sensitized guinea pig esophagus could be a good model to study the role of esophageal MCs in allergic and inflammation conditions.