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  Background & Objectives: Esophageal carcinoma has more prevalency in northwest of Iran. Relapsing dysphagea after esophagectomy is one of the common delayed complication. It emerges due to technique of surgery. Reflux and or leakage in anastomotic area. The aim of this study is to evaluate the prevalence and etiologies of dysphagea after esophagectomy and postoperative endoscopic dilation results.

  Methods: This is a retrospective discreptive study, during 2000-2005 at Imam Khomeini hospital, all patients who had esophagectomy because of esophageal carcinomas entered this study. Data collected from medical records, Primary tumoral diagnosis, operation endoscopy, dysphagea, histopathological findings, Postoperative complications, especially dysphagia and it’s etiology, and different methods of therapy, reoperation and or endoscopic dilatation were studied.

  Results: Among 324 patients 81 patients had esophagectomy for esophageal carcinomas. In eighteen patients (22.2%), dysphagea reappered after operation. Rate of dysphagea in patients with carcinoma of lower one third area was 5.3 times greater than middle third of the esophagus. Mean time between first hospitalization and second hospitalization due to relapsing dysphagea was 10.03 months. The main cause of relapsing dysphagia in 88.24%, was benign stricture in anastomotic area. 17 patients with endoscopic dilation and one patient with surgical stricturoplasty, were treated.

Conclusion: Relapsing dysphagea after esophagectomy is common in our patients. This represents mostly benign strictures after esophagectomies for esophageal carcinoma. In benign anastomotic strictures, endoscopic dilation is an effective treatment and it is recommended.

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  Background & objectives: Hypocalcaemia is one of the severe complications of total thyroidectomy. This complication occurs due to parathyroid glands damage during operation. The aim of this study was to evaluate the frequency of transitory and permanent hypocalcaemia in patients who were subjected to total thyroidectomy and the role of the parathyroid autotransplantation on permanent hypocalcaemia .

  Methods: In this retrospective study, one hundred patients who suffered from malignant ( group I, 46 persons) and benign (group II, 54 persons) thyroid diseases and subjected to total thyroidectomy were included and preventing role of parathyroid autotransplantation�on hypocalcaemia (permanent and transitory) was studied. Of 37 individuals of the group I who were treated with total thyroidectomy, 3 patients (subgroup A) were autotranspalnted with parathyroid glands and the rests (9 persons) who their neck lymph nodes were dissected radically and then undergone total thyroidectomy , 4 patients (subgroup B) were accomplished the autotranspalntation . In group II, just 2 patients were autotranspalnted. In overall, only in 9% of cases the autotranspalntations were done into sternocleidomastoid and deltoid muscle fibers.

  Results: Sixty seven percent of the patients were female with average age of 39.9 ± 10.8 years and 33% were male with average age of 37.2 ± 8.8 years. Seventeen percent of the patients showed transitory hypocalcaemia (13 persons in group I: 8 persons in subgroup A and 5 persons in subgroup B, 4 persons in group II). They were treated with intravenous and oral calcium supplements. None of patients progressed to permanent hypocalcaemia. The recovery rate obtained by the autotransplantation was significant statistically between two groups (p=0.006) and two subgroups (p=0.04). Temporary recurrent laryngeal nerve paresis also occurred in 2% of patients but no paralysis was observed.

  Conclusion: The autotransplantation of injured or incidentally removed parathyroid glands into sternocleidomastoid or deltoid muscle fibers can prevent the permanent hypocalcaemia.