Esophagectomies with Therapeutic Options in Esophageal Cancer
Keywords:
esophagectomy, fistula, pneumoniaAbstract
Introduction: Esophagectomy is the procedure of choice in the surgical treatment of esophageal cancer associated with a high frequency, variety of complications and high mortality rates. Its complication rates are related to a combination of factors, such as the appropriate choice of a respective technique, the competence of the operating team, and the quality of perioperative care.
Objective: To characterize the surgical treatment of esophageal cancer.
Methods: A retrospective and observational study was conducted in the surgery service of Hospital Clínico Quirúrgico Hermanos Ameijeiras, between September 2018 and March 2021, in a study universe of 68 patients, from which a sample of 18 patients was taken, who underwent elective subtotal esophagectomy for esophageal cancer. The studied variables were the histological type of cancer, the used variant of surgical technique, the presence and type of complication, as well as mortality.
Results: The Orringer technique (transhiatal) was the most frequently used, accounting for 11 esophagectomies; while the three-stage Mc Keown operation was performed in 5 patients. The most frequent complications were anastomosis site fistula and postoperative pneumonia.
Conclusions: Esophagectomy and restoration of the gastrointestinal tract are complex, challenging procedures of choice in resectable esophageal cancer. The most commonly used surgical technique is transhiatal esophagectomy, whose most frequent complications are anastomotic fistula at the cervical level and pneumonia, but with no immediate and mediate postoperative mortality.
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