Intrathoracic anastomosis after oesophageal resection for cancer

Autor: Ramakant K Deshpande, Prakash K. Patil, Rajendra A. Badwe, Shefali Agrawal, Rajiv G. Bhatt, Prafulla B. Desai, Mehul S. Bhansali, Sanjay P. Deshmukh
Rok vydání: 1996
Předmět:
Zdroj: Journal of Surgical Oncology. 63:52-56
ISSN: 1096-9098
0022-4790
Popis: Cervical anastomosis has been advocated to avoid the pulmonary complications and life-threatening anastomotic disruptions following intrathoracic oesophagogastric anastomosis. This is a retrospective review of 111 oesophageal resections followed by an intrathoracic anastomosis. These resections were performed between September 1993 and August 1994 within a residency training program. The left thoracoabdominal approach was used for distal tumours and the Ivor Lewis technique for more proximal tumours. Squamous cell carcinoma accounted for 72% patients (n = 80), adenocarcinoma for 25% (n = 28), and others for 2.7% patients (n = 3). Of the patients, 69% had pathologic Stage III tumours. Operative mortality rate was 1.8% (two patients). Perioperative complications occurred in 39 patients, including anastomotic leak in 10 patients and myocardial infarction in 2 patients. In the absence of a leak, there were no major pulmonary complications requiring intensive care or ventilatory support. Of those patients with anastomotic disruption, 80% were salvaged by early clinical diagnosis and appropriate treatment. We conclude that transthoracic oesophagectomy with an intrathoracic anastomosis is a safe procedure that can be performed with low mortality and acceptable morbidity.
Databáze: OpenAIRE
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