TY - JOUR
T1 - Esophagectomy for eosinophilic esophagitis
T2 - Case report and literature review
AU - Irino, Tomoyuki
AU - Voultsos, Mavroudis
AU - Tsai, Jon A.
AU - Lindblad, Mats
AU - Nilsson, Magnus
AU - Rouvelas, Ioannis
PY - 2016/8/1
Y1 - 2016/8/1
N2 - Background: Eosinophilic esophagitis (EoE) is a chronic allergen-driven disease in which eosinophilic infiltration of the esophagus results in fibrosis, causing symptoms of esophageal dysfunction. The natural history of EoE frequently results in progressive deterioration of patients’ quality of life. In selected cases, progressive manifestations of disease cannot be managed with the conventional treatment options, and patients therefore suffer from poor quality of life. Methods: We present the case of a 27-year-old male patient whose therapy for long-standing EoE did not prevent his clinical deterioration, which in turn gradually led to worsening quality of life owing to the degree and extent of esophageal fibrosis-associated remodeling. The patient eventually underwent a combined thoracoscopic/laparoscopic esophagectomy as a last resort aimed at alleviating the severe esophageal dysfunction and poor quality of life that he experienced. Results: The patient underwent a minimally invasive esophagectomy and recovered quickly, gaining weight as early as 4 weeks after surgery. The patient returned 5 months later complaining of dysphagia regarding solid food. Gastroscopy showed a mild anastomotic stenosis that was dilated to 18 mm. During follow-up, the patient gained 15 kg compared with his lowest body weight prior to surgery and has remained symptom free 2.5 years after his surgery. Conclusion: Surgery can be considered as a last-resort option for managing the refractory manifestations of EoE and its complications.
AB - Background: Eosinophilic esophagitis (EoE) is a chronic allergen-driven disease in which eosinophilic infiltration of the esophagus results in fibrosis, causing symptoms of esophageal dysfunction. The natural history of EoE frequently results in progressive deterioration of patients’ quality of life. In selected cases, progressive manifestations of disease cannot be managed with the conventional treatment options, and patients therefore suffer from poor quality of life. Methods: We present the case of a 27-year-old male patient whose therapy for long-standing EoE did not prevent his clinical deterioration, which in turn gradually led to worsening quality of life owing to the degree and extent of esophageal fibrosis-associated remodeling. The patient eventually underwent a combined thoracoscopic/laparoscopic esophagectomy as a last resort aimed at alleviating the severe esophageal dysfunction and poor quality of life that he experienced. Results: The patient underwent a minimally invasive esophagectomy and recovered quickly, gaining weight as early as 4 weeks after surgery. The patient returned 5 months later complaining of dysphagia regarding solid food. Gastroscopy showed a mild anastomotic stenosis that was dilated to 18 mm. During follow-up, the patient gained 15 kg compared with his lowest body weight prior to surgery and has remained symptom free 2.5 years after his surgery. Conclusion: Surgery can be considered as a last-resort option for managing the refractory manifestations of EoE and its complications.
KW - Benign esophageal stricture
KW - Eosinophilic esophagitis
KW - Esophageal resection
KW - Quality of life
KW - Surgery
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U2 - 10.1007/s10353-016-0433-1
DO - 10.1007/s10353-016-0433-1
M3 - Article
AN - SCOPUS:84975295493
VL - 48
SP - 241
EP - 245
JO - Acta Chirurgica Austriaca
JF - Acta Chirurgica Austriaca
SN - 1682-8631
IS - 4
ER -