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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What is esophageal rupture?

By way of background, in February, 2005, I was diagnosed with Stage 3, borderline Stage 4, neck and throat cancer (squamous cell carcinoma). The diagnosis was followed almost immediately by a radical neck dissection. It was determined that the cancer originated in my left tonsil and spread rapidly into the left side of my neck, involving 40 of the 48 lymph nodes that were removed. Three weeks after surgery, I began a six-month course of radiation therapy, enhanced by chemotherapy. Prior to starting this treatment, a feeding tube was inserted through my stomach wall. Once the treatments began, I did not eat or drink by mouth and my esophagus was not monitored during the course of the treatments. About three weeks after the completion of treatment, I was advised that I could commence eating soft foods. At this time I learned that I had developed total esophageal stinosis. After a seven month search, I found a doctor at the M D Anderson cancer center in Houston, Texas who had performed five experimental operations to try to reverse similar conditions in others. I would become the sixth patient to undergo this procedure, which required two surgeons, one who used a pediatric scope to approach the stricture through the feeding tube canal and the primary surgeon who inserted a scope through my mouth. Over the course of several hours, they were able to rendezvous and thread a thin wire through the blocked portion of the esophagus. They then used a procedure similar to angioplasty to dilate the esophagus to approximately 18 millimeters. This initial surgery was followed over the course of a year with a half dozen conventional dilatations to try to restore my esophagus to allow me to eat soft foods. These subsequent procedures failed and resulted in a small tear in my esophagus. That was the last attempt. The end result is that a small section of my esophagus in the area of my epiglottis is only about 6 mm in diameter and my epiglottis does not function normally. I am only able to ingest liquids using a supraglottic swallowing procedure. I am a 65 year-old male who is otherwise in excellent health. I am extremely active and avidly pursue long-range cruising sailing in my retirement and have found the time to author a book about my travels entitled Manning Up In Alaska and launch the Sail Through Cancer Foundation. I am interested in pursuing further options to enhance my ability to swallow and ingest soft or conventional food. I am aware of various attempts to re-grow and replace parts of the esophagus using different strategies involving stem cells. I m wonder if you re aware of any recent experimental or other procedures that might improve my condition because I would be interested in participating in such an experimental procedure under certain conditions.
Fri, 11 Jun 2021
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General Surgeon 's  Response
Hi,

Radiotherapy might have caused the esophageal stricture and I am sure during dilation they must have taken biopsy and CT scan must have been done to know the cause. Stricture and perforation of esophagus is rare but known to be dangerous as the prognosis is always guarded.
It would be worthwhile to try the new procedure your Doctor has mentioned. Till then you can request for feeding jejunostomy so that you get natural foods, supplements and medication. This is a simple procedure and life-saving in many patients. Proper clinical and radiological evaluation will tell the further course of procedures and prognosis.

Take care. Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. T. Chandrakant, General Surgeon
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What is esophageal rupture?

Hi, Radiotherapy might have caused the esophageal stricture and I am sure during dilation they must have taken biopsy and CT scan must have been done to know the cause. Stricture and perforation of esophagus is rare but known to be dangerous as the prognosis is always guarded. It would be worthwhile to try the new procedure your Doctor has mentioned. Till then you can request for feeding jejunostomy so that you get natural foods, supplements and medication. This is a simple procedure and life-saving in many patients. Proper clinical and radiological evaluation will tell the further course of procedures and prognosis. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. T. Chandrakant, General Surgeon