Surgical treatment of esophageal carcinoma: Examination of our cases in the last 13 years

Özofagus kanserinin cerrahi tedavisi ( Son 13 senelik olgularımızın irdelenmesi )

Abstract

70 patients with esophageal carcinoma diagnosed and treated at the Department of Surgery, Cerrahpaşa Medical Faculty of Istanbul University between 1985-1997 were retrospectively analyzed and the results of our surgical experience were examined. Preoperative diagnosis and preparation to surgery, operability criterias, TNM clasification, postoperative management, the rates of morbidity and mortality, the prognosis were examined. 45 (% 64) and 20 (% 29) of 65 (% 93) patients considered operabl preoperatively underwent resection and palliative procedures respectively. The 7 % of patients were in Stage 1, 60 % in Stage 2, 26 % in Stage 3 and 7 % in Stage 4. The mean postoperative hospitalisation period was 19±3 (14-23) days. The total morbidity rate in early postoperative period was 12.7 %. The colon and stomach were used for interposition in 4 and 1 of 5 patients with anastomotic leakage respectively and all of the patients had cervical fistulisation. The rate of early postoperative mortality was 5.7 % (2 with cardiac insufficiency, 1 with pulmonary insufficiency and 1 with pulmonary embolism). The mean survival time was 43.5±2.2 months in the group of Stage 1-2 patients, 15.8±0.8 months in the group of Stage 3 patients. 8±1.2 months in the group of Stage 4 patients. The overall survival rate was 60 % in the group of Stage 1-2 patients, 56.2 % in the group of Stage 3 patients and 0 % in the group of Stage 4 patients (p

Özet

İ.Ü. Cerrahpaşa Tıp Fakültesi Genel Cerrahi Anabilim Dalında 1985-1997 yıllan arasında tarafımızdan teşhis ve tedavi edilen Özofagus kanserli 70 hasta retrospektif olarak analiz edildi ve cerrahi deneyimimizin sonuçları irdelendi. Preoperatif teşhis ve ameliyat için hazırlıklar, operabilite kriterleri, TNM sınıflaması, uygulanan cerrahi teknikler, postoperatif uygulamalar, morbidite ve mortalite oranları, prognoz incelendi. Preoperatif operabl olarak düşünülen 65 (% 93) hastanın 45 (% 64)'ine rezeksiyon, 20 (% 29)'sine palyatif işlem yapıldı. Hastaların % 7'si Evre l, % 60'ı Evre 2, % 26'sı Evre 3 ve % 7'si Evre 4'de idi. Postoperatif hastahanede yatış süresi ortalama 19±3 (14-23) gündü. Postoperatif erken dönemdeki toplam morbidite oranı % 12.7 idi. Anastomoz kaçağı olan 5 hastanın 4'ünde kolon, 1'inde mide interpozisyonu yapılmıştı ve hepside servikal fistüldü. Postoperatif erken mortalite % 5.7 (2 kalp yetmezliği, 1 solunum yetmezliği, 1 akciğer emholisi) idi. Ortalama yaşam zamanı Evre 1-2 hasta grubunda 43.5+2.2 ay, Evre 3 hasta grubunda 15.8±0.8 ay ve Evre 4 hasta grubunda 8±1.2 ay bulundu. Tüm grupların birleşik yaşam oranı Evre 1-2 hasta gru-bunda % 60, Evre 3 hasta grubunda % 56.2 ve Evre 4 hasta grubunda % O olarak saptandı (p