COMPLICATIONS OF THE RESCUE ESOPHAGECTOMY IN ADVANCED ESOPHAGEAL CANCER

被引:7
作者
Braga de Aquino, Jose Luis [1 ]
Said, Marcelo Manzano
Rizzanti Pereira, Douglas Alexandre
Cecchino, Gustavo Nardini
Leandro-Merhi, Vania Aparecida
机构
[1] Pontificia Univ Catolica Campinas, Celso Pierro Matern & Hosp, Fac Med, Dept Thorac Surg, Campinas, SP, Brazil
来源
ABCD-ARQUIVOS BRASILEIROS DE CIRURGIA DIGESTIVA-BRAZILIAN ARCHIVES OF DIGESTIVE SURGERY | 2013年 / 26卷 / 03期
关键词
Thoracic surgery; Esophagectomy; Neoplasms;
D O I
10.1590/S0102-67202013000300004
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background: Even though the esophageal cancer has innumerous treatment options its prognosis is still unsettled. Because esophagectomy is rarely curative, new and emerging therapies come to light such as isolated chemotherapy and radiotherapy or combined chemoradiation, followed or not by surgery. The rescue esophagectomy is an alternative for those patients with recurrent or advanced disease. Aim: To evaluate the results of the rescue esophagectomy in patients with esophageal cancer who had previously undergone chemoradiation and describe local and systemic complications of the procedure. Methods: Eighteen patients with unresectable esophageal squamous cell carcinoma were treated with chemoradiation followed by rescue esophagectomy. All of them presented the preoperative clinical conditions required to indicate the surgical procedure. Transthoracic esophagectomy with right side thoracotomy plus midline laparotomy was performed. Patients were evaluated with regard to any postoperative complications. Results: There were five patients with evidence of fistula at the level of the anastomosis, and four of them progressed satisfactorily. Postoperative dilation was needed in five out of eighteen patients due to stenosis of the esophagogastric suture line. Seven patients did develop pulmonary infection with a fatal outcome for two of them. Among the patients who were available for a five-year follow-up, there was a rate of 53.8% of disease-free survival. Conclusions - These patients presented an elevated morbidity of the procedure related to many factors such as the long period between chemoradiation and surgery, which leads to tissue injury resulting in anastomotic fistulas. Nevertheless, esophagectomy seems to be valuable in cases without any other therapeutic option.
引用
收藏
页码:173 / 178
页数:6
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