Surgical Treatment of Esophageal Cancer

식도종양의 외과적 치료

  • Published : 1995.02.01

Abstract

Fourty nine patients out of 127 esophageal cancer were managed surgically from January 1986 to December 1991, at the Department of Thoracic and Cardiovascular Surgery, Jeonbuk National University Hospital. Most frequent preoperative symptom was dysphagia and its mean duration was 3.1 months. In histopathologic examination, squamous cell carcinomas were 44 cases [89.8% , and adenocarcinomas 5 [10.2% . The tumor location were the upper esophagus in 6.1%, middle esophagus in 57.2%, lower and cardiac portion of stomach in 36.7%. Involved and metastatic organs, which were detected perioperatively, were celiac lymph nodes in 6 cases, aorta 2, stomach 2, pericardium 2, cervical lymph node 1. The esophagus was resected radically, and the procedures for esophageal replacement were performed with esophagogastrostomy in 45 cases, esophagocologastrostomy 3, and esophagojejunostomy 1. Postoperative complications occurred in 16 cases [hospital morbidity = 32.6% ,anastomotic leak 3, anastomotic stricture 2, respiratory insufficiency 2, hemoperitoneum 1, chylothorax 1, intussusception 1, empyema 1, non-A,non-B hepatitis 1, and mediastinitis 1. Hospital deaths were experienced 3 cases [ hospital mortality = 6.1% . The 6 month, one, two, and five year actuarial survival rates were 85.7%, 71.4%, 57.1%, and 27.9%, respectively. One year survival rates of stages were 100% in stage I, 90.9% in stage IIa, 63.6% in stage IIb, 25.0% in stage III, and 7.2% in stage IV.

Keywords

References

  1. Management of Esophageal Disease Skinner,D.B.
  2. Ann Thorac Surg v.194 Principles of Treatment for Carcinima of the Esophagus:analysis of lymph node involvement Akiyama,H.;Tsurumaruu,M.;Kawamura,T.;Ono,T.
  3. 대흉회지 v.25 식도암의 외과적 요법에 대한 임상적 고찰 김기봉;정철현;이정상;성숙환;김주현
  4. Manual for staging of cancer(3rd Ed.) Beahrs,O.H.;Henson,D.E.;Hutter,R.V.H.;Myers,M.H.
  5. TNM atlas:Illustrated guide to the TNM/pTNM classfication of malignant tumors(4th Ed.) Spiessl,B.;Bears,O.H.;Hermanek,P.(et al)
  6. Glenn's Thoracic & Cardiovascular Surgery(5th Ed.) Baue,A.E.;Geha,A.S.;Hammond,G.L.;Laks,H.;Naunheim,K.S.
  7. 임상 병리 식도암 취급의 규약:Guide Lines for the clinical and pathologic studies on carcinoma of the esophagus Japanese Society for Esophageal Disease
  8. J Thorac Cardiovasc Surg v.76 Esophagectomy without thoracotomy Orringer,M.B.;Sloan,H.
  9. Surg Clin North Am v.60 Esophagogastrectomy for carcinoma:Technical consideration based on anatomic location of lesion Ellis,F.H.
  10. Am J Surg v.153 Esophageal resection for cancer:The rationale of current practive Wong,J.
  11. Ann Surg v.188 Use of the stomach as an esophageal substitute Akiyama,H.;Miyzono,H.;Tsurumaru,M.;Hashimito,C.;Kawamura,T.
  12. Am J Surg v.J47 Stapled esophagogastric anastomosis Hopkins,F.A.;Alexander,J.C.;Postlewait,R.W.
  13. Am J Surg v.139 Esophageal reconstruction Skinner,D.B.
  14. 대흉외지 v.23 EEA Stapler를 이용한 식도암 수술의 조기성적 조성래;허강배;김창수 등
  15. Cancer v.54 Esophageal Carcinoma David,J.M.;Walter,B.F.;Barbara,B.
  16. N Engl J Med v.260 Carcinoma of the esophagus and cardia. Result of Treatment 1946 to 1959 Ellis,F.H.;Claett,O.T.;Gage,R.P.
  17. Ann Thorac Surg v.15 Primary malignant tumors of the esophagus other than typical epidermoid epidenoma Turnbull,A.P.;Rosen,P.;Goodner,J.T.;Beattie,E.J.
  18. J Thorac Cardiovasc Surg v.46 The Surgical treatment of carcinoma of the esophagus & cardia Logan,H.
  19. 대흉외지 v.25 식도암의 외과적 조기관찰 성적 오봉석;민용일;김보영;이동준