Vijayakumar Manavalan, Burrah Rajaram, Hari Kaushik, Veerendra K V, Krishnamurthy S
Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka 560029 India.
Department of Surgical Oncology, St John's Medical College Hospital, Bangalore, Karnataka 560034 India.
Indian J Surg Oncol. 2013 Dec;4(4):332-5. doi: 10.1007/s13193-013-0260-9. Epub 2013 Aug 10.
Surgery is an important component of treatment for patients with resectable cancer of the mid and lower third of the esophagus. There are many controversies associated with esophagectomy. We share our experience with esophagectomy for cancer of the mid and lower third of the esophagus. Between January 2007 and December 2011, 210 patients with cancer of the esophagus underwent surgery. The patients' pre and intra- operative factors, morbidities and mortality were noted and studied. Transhiatal esophagectomy was done in 175 patients and right transthoracic esophagectomy was done in 35 patients. The most common location of the tumor was lower third and most common histopathology was squamous cell carcinoma. There were 5 in-hospital deaths (2.4 %) and the common morbidities encountered were respiratory (30 %), anastomotic leak (5 %) and anastomotic stricture (15 %). The morbidity was higher in the transthoracic group. Our R0 resection rate was 89 %. Esophagectomy can be accomplished with acceptable morbidity in the management of patients with oesophageal cancer. We attribute the favourable results to the high volume at our centre, surgical expertise, good patient selection and performance of the anastomosis in the neck.
手术是食管中下段可切除癌患者治疗的重要组成部分。食管癌切除术存在诸多争议。我们分享食管中下段癌切除术的经验。2007年1月至2011年12月期间，210例食管癌患者接受了手术。记录并研究了患者的术前和术中因素、发病率及死亡率。175例行经裂孔食管切除术，35例行右胸段食管切除术。肿瘤最常见的部位是下段，最常见的组织病理学类型是鳞状细胞癌。有5例住院死亡（2.4%），常见的并发症有肺部（30%）、吻合口漏（5%）和吻合口狭窄（15%）。胸段手术组的发病率更高。我们的R0切除率为89%。在食管癌患者的治疗中，食管切除术可在可接受的发病率下完成。我们将良好的结果归因于我们中心的高手术量、手术专业技能、良好的患者选择以及颈部吻合口的操作。
