Total esophagogastrectomy in the neoplasms of the esophagus and esofagogastric junction: when must be indicated?
Autor(a) principal: | |
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Data de Publicação: | 2015 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Revista do Colégio Brasileiro de Cirurgiões |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-69912015000700360 |
Resumo: | Objective: to analyse the indications and results of the total esophagogastrectomy in cancers of the distal esophagus and esophagogastric junction. Methods: twenty patients with adenocarcinomas were operated with a mean age of 55 ± 9.9 years (31-70 years), and 14 cases were male (60%). Indications were 18 tumors of the distal esophagus and esophagogastric junction (90%) and two with invasion of gastric fundus (10%) in patients with previous gastrectomy. Preoperative colonoscopy to exclude colonic diseases was performed in ten cases. Results: the surgical technique consisted of median laparotomy and left cervicotomy, followed by transhiatal esophagectomy associated with D2 lymphadenectomy. The reconstructions were performed with eight esophagocoloduodenoplasty and the others were Roux-en-Y esophagocolojejunoplasty to prevent the alkaline reflux. Three cases were stage I / II, while 15 cases (85%) were stages III / IV, reflecting late diagnosis of these tumors. The operative mortality was 5 patients (25%): a mediastinitis secondary to necrosis of the transposed colon, abdominal cellulitis secondary to wound infection, severe pneumonia, an irreversible shock and sepsis associated with colojejunal fistula. Four patients died in the first year after surgery: 3 (15%) were due to tumor recurrence and 1 (5%) secondary to bronchopneumonia. The 5-year survival was 15%. Conclusion: the total esophagogastrectomy associated with esophagocoloplasty has high morbidity and mortality, requiring precise indication, and properly selected patients benefit from the surgery, with the risk-benefit acceptable, contributing to increased survival and improved quality of life |
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Revista do Colégio Brasileiro de Cirurgiões |
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Total esophagogastrectomy in the neoplasms of the esophagus and esofagogastric junction: when must be indicated?AdenocarcinomaEsophagusSurgical Procedures, OperativeEsophagectomy Objective: to analyse the indications and results of the total esophagogastrectomy in cancers of the distal esophagus and esophagogastric junction. Methods: twenty patients with adenocarcinomas were operated with a mean age of 55 ± 9.9 years (31-70 years), and 14 cases were male (60%). Indications were 18 tumors of the distal esophagus and esophagogastric junction (90%) and two with invasion of gastric fundus (10%) in patients with previous gastrectomy. Preoperative colonoscopy to exclude colonic diseases was performed in ten cases. Results: the surgical technique consisted of median laparotomy and left cervicotomy, followed by transhiatal esophagectomy associated with D2 lymphadenectomy. The reconstructions were performed with eight esophagocoloduodenoplasty and the others were Roux-en-Y esophagocolojejunoplasty to prevent the alkaline reflux. Three cases were stage I / II, while 15 cases (85%) were stages III / IV, reflecting late diagnosis of these tumors. The operative mortality was 5 patients (25%): a mediastinitis secondary to necrosis of the transposed colon, abdominal cellulitis secondary to wound infection, severe pneumonia, an irreversible shock and sepsis associated with colojejunal fistula. Four patients died in the first year after surgery: 3 (15%) were due to tumor recurrence and 1 (5%) secondary to bronchopneumonia. The 5-year survival was 15%. Conclusion: the total esophagogastrectomy associated with esophagocoloplasty has high morbidity and mortality, requiring precise indication, and properly selected patients benefit from the surgery, with the risk-benefit acceptable, contributing to increased survival and improved quality of lifeColégio Brasileiro de Cirurgiões2015-12-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-69912015000700360Revista do Colégio Brasileiro de Cirurgiões v.42 n.6 2015reponame:Revista do Colégio Brasileiro de Cirurgiõesinstname:Colégio Brasileiro de Cirurgiões (CBC)instacron:CBC10.1590/0100-69912015006002info:eu-repo/semantics/openAccessAndreollo,Nelson AdamiCoelho Neto,João de SouzaCalomeni,Guilherme DelfinoLopes,Luiz RobertoTercioti Junior,Valdireng2016-01-20T00:00:00Zoai:scielo:S0100-69912015000700360Revistahttp://www.scielo.br/rcbcONGhttps://old.scielo.br/oai/scielo-oai.php||revistacbc@cbc.org.br1809-45460100-6991opendoar:2016-01-20T00:00Revista do Colégio Brasileiro de Cirurgiões - Colégio Brasileiro de Cirurgiões (CBC)false |
dc.title.none.fl_str_mv |
Total esophagogastrectomy in the neoplasms of the esophagus and esofagogastric junction: when must be indicated? |
title |
Total esophagogastrectomy in the neoplasms of the esophagus and esofagogastric junction: when must be indicated? |
spellingShingle |
Total esophagogastrectomy in the neoplasms of the esophagus and esofagogastric junction: when must be indicated? Andreollo,Nelson Adami Adenocarcinoma Esophagus Surgical Procedures, Operative Esophagectomy |
title_short |
Total esophagogastrectomy in the neoplasms of the esophagus and esofagogastric junction: when must be indicated? |
title_full |
Total esophagogastrectomy in the neoplasms of the esophagus and esofagogastric junction: when must be indicated? |
title_fullStr |
Total esophagogastrectomy in the neoplasms of the esophagus and esofagogastric junction: when must be indicated? |
title_full_unstemmed |
Total esophagogastrectomy in the neoplasms of the esophagus and esofagogastric junction: when must be indicated? |
title_sort |
Total esophagogastrectomy in the neoplasms of the esophagus and esofagogastric junction: when must be indicated? |
author |
Andreollo,Nelson Adami |
author_facet |
Andreollo,Nelson Adami Coelho Neto,João de Souza Calomeni,Guilherme Delfino Lopes,Luiz Roberto Tercioti Junior,Valdir |
author_role |
author |
author2 |
Coelho Neto,João de Souza Calomeni,Guilherme Delfino Lopes,Luiz Roberto Tercioti Junior,Valdir |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Andreollo,Nelson Adami Coelho Neto,João de Souza Calomeni,Guilherme Delfino Lopes,Luiz Roberto Tercioti Junior,Valdir |
dc.subject.por.fl_str_mv |
Adenocarcinoma Esophagus Surgical Procedures, Operative Esophagectomy |
topic |
Adenocarcinoma Esophagus Surgical Procedures, Operative Esophagectomy |
description |
Objective: to analyse the indications and results of the total esophagogastrectomy in cancers of the distal esophagus and esophagogastric junction. Methods: twenty patients with adenocarcinomas were operated with a mean age of 55 ± 9.9 years (31-70 years), and 14 cases were male (60%). Indications were 18 tumors of the distal esophagus and esophagogastric junction (90%) and two with invasion of gastric fundus (10%) in patients with previous gastrectomy. Preoperative colonoscopy to exclude colonic diseases was performed in ten cases. Results: the surgical technique consisted of median laparotomy and left cervicotomy, followed by transhiatal esophagectomy associated with D2 lymphadenectomy. The reconstructions were performed with eight esophagocoloduodenoplasty and the others were Roux-en-Y esophagocolojejunoplasty to prevent the alkaline reflux. Three cases were stage I / II, while 15 cases (85%) were stages III / IV, reflecting late diagnosis of these tumors. The operative mortality was 5 patients (25%): a mediastinitis secondary to necrosis of the transposed colon, abdominal cellulitis secondary to wound infection, severe pneumonia, an irreversible shock and sepsis associated with colojejunal fistula. Four patients died in the first year after surgery: 3 (15%) were due to tumor recurrence and 1 (5%) secondary to bronchopneumonia. The 5-year survival was 15%. Conclusion: the total esophagogastrectomy associated with esophagocoloplasty has high morbidity and mortality, requiring precise indication, and properly selected patients benefit from the surgery, with the risk-benefit acceptable, contributing to increased survival and improved quality of life |
publishDate |
2015 |
dc.date.none.fl_str_mv |
2015-12-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-69912015000700360 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-69912015000700360 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/0100-69912015006002 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Colégio Brasileiro de Cirurgiões |
publisher.none.fl_str_mv |
Colégio Brasileiro de Cirurgiões |
dc.source.none.fl_str_mv |
Revista do Colégio Brasileiro de Cirurgiões v.42 n.6 2015 reponame:Revista do Colégio Brasileiro de Cirurgiões instname:Colégio Brasileiro de Cirurgiões (CBC) instacron:CBC |
instname_str |
Colégio Brasileiro de Cirurgiões (CBC) |
instacron_str |
CBC |
institution |
CBC |
reponame_str |
Revista do Colégio Brasileiro de Cirurgiões |
collection |
Revista do Colégio Brasileiro de Cirurgiões |
repository.name.fl_str_mv |
Revista do Colégio Brasileiro de Cirurgiões - Colégio Brasileiro de Cirurgiões (CBC) |
repository.mail.fl_str_mv |
||revistacbc@cbc.org.br |
_version_ |
1754209213163241472 |