Œsophage

Résumé

L' (du grec οισοφάγος, littéralement « qui transporte ce qu'on mange ») est un organe appartenant au tube digestif, principalement thoracique et communiquant avec le pharynx au niveau du cou et l'estomac au niveau de l'abdomen. Il permet de transporter les aliments solides et liquides déglutis vers l'estomac grâce au péristaltisme, l'onde séquentielle de sa musculature. Il a une longueur de chez l'être humain adulte et chez le nouveau-né. Anatomie vignette|Coupe axiale du thorax au niveau T5. L'œsophage est le segment du tube digestif qui relie le pharynx au cardia de l'estomac. L'œsophage possède trois portions, reflétant les trois régions anatomiques qu'il traverse : œsophage cervical, œsophage thoracique et œsophage abdominal. À sa limite supérieure, il possède une valve appelée ou encore bouche œsophagienne de Kilian. Cet orifice se situe à environ 15 cm des arcades dentaires. À sa limite inférieure, il n'existe pas de sphincter anatomique, mais un sphincter fonct

Source officielle

https://fr.wikipedia.org/wiki/%C5%92sophage

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Assessment of a sheep animal model to optimize photodynamic therapy with Foscan in the esophague

François André Borle, Hubert van den Bergh, Georges Wagnières, Matthieu Zellweger

Precursor lesions of oesophagus adenocarcinoma constitute a clinical dilemma. Photodynamic therapy (PDT) is an effective treatment for this indication, but it is difficult to optimise without an appropriate animal model. For this reason, we assessed the sheep model for PDT in the oesophagus with the photosensitiser meta-(tetra-hydroxyphenyl) chlorin (mTHPC).

Wiley-Blackwell2009

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, ,

Cancer, when detected at an early stage, has a very good probability of being eradicated by surgery or radiotherapy. However, less aggressive treatments also tend to provide high rates of cure without the side effects of radical therapy. We report on the results of our clinical experience with photodynamic therapy (PDT) for the treatment of early carcinomas in the upper aerodigestive tract, the esophagus, and the tracheobronchial tree. Sixty-four patients with 101 squamous cell carcinomas were treated with three different photosensitizers: hematoporphyrin derivative (HPD), Photofrin II, and tetra (m-hydroxyphenyl)chlorin (mTHPC). Seventy-seven (76%) tumors showed a complete rsponse with no recurrence after a mean follow-up period of 27 months. There was no significant difference in terms of cure rates among the three dyes. However, mTHPC has a stronger phototoxicity and induces a shorter skin photosensitization than either of the other photosensitizers. There were eight major complications: three esophagotracheal fistulae after illumination with red light in the esophagus, two esophageal stenoses following 360 degrees circumferential irradiation, and three bronchial stenoses. Illumination with the less penetrating green light and the use of a 180 degrees or 240 degrees windowed cylindrical light distributor render the risk of complications in the esophagus essentially impossible, without reducing the efficacy of the treatment. Therefore, PDT may be considered as a safe and effective treatment for early carcinomas of the upper aerodigestive tract, the esophagus, and the tracheobronchial tree.

Hindawi Publishing Corporation1999

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Light dosimetry for photodynamic therapy in the esophagus

Hubert van den Bergh, Georges Wagnières

BACKGROUND AND OBJECTIVE: Photodynamic therapy (PDT) is an efficient technique to treat superficial early cancers in the pharynx, esophagus, and tracheo-bronchial tree. However, the lack of selectivity of some of the clinically used photosensitizers can result in significant damage to the healthy tissue during the treatment. In the esophagus, this may lead to medical complications such as stenosis and fistula. Insufficient selectivity may be compensated to some extent by accurate light dosimetry. Here, we present an approach to safer and more efficient PDT by improved light dosimetry in the esophagus. STUDY DESIGN/MATERIALS AND METHODS: This includes the utilization of a suitable light distributor, the estimation of the radiant energy density in the tissue, and the knowledge of the esophagus morphology. The light distributor presently used in the clinic is described and several techniques to study light propagation in the esophageal wall have been investigated and are discussed. Thickness of different histological layers of the esophageal wall have been measured ex vivo and are presented. RESULTS: Under these conditions and based on a simple model of the light distribution in the tissue, some basic and clinically useful notions of light dosimetry can be drawn. These notions, associated with measured value of tissue optical properties at the wavelengths of interest with the presently used photosensitizers, are discussed regarding the particular morphology of the esophageal wall. In particular, the importance of the illumination wavelength from the safety point of view is shown. CONCLUSION: The proposed approach allows for improved safety and efficacy of PDT in the esophagus, particularly in the clinical tests of new photosensitizers.

1997

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