التفاصيل البيبلوغرافية
| العنوان: |
A single surgeon's series of transthoracic oesophageal resections. |
| المؤلفون: |
Beasley, W. D., Jefferies, M. T., Gilmour, J., McK Manson, J. |
| المصدر: |
Bulletin of The Royal College of Surgeons of England; Feb2014, Vol. 96 Issue 2, p151-156, 6p |
| مصطلحات موضوعية: |
ESOPHAGEAL cancer, ESOPHAGEAL surgery, CANCER treatment, CANCER chemotherapy, SURGERY |
| مستخلص: |
INTRODUCTION Significant controversy persists over the optimum surgical management of oesophageal carcinoma. The authors report on a consecutive personal series of open transthoracic oesophageal resections. METHODS Data relating to resections performed between mid-1993 and the end of 2010 were analysed. Patient and tumour assessment evolved over this period. Preoperative chemotherapy in appropriate cases was introduced in 2002. A laparotomy and right lateral thoracotomy approach (Ivor--Lewis) was used. In all cases the pylorus was not interfered with, no attempt was made to perform a radical lymphadenectomy but surgical strategy was focused on producing an R0 resection and a hand sewn anastomosis was fashioned. RESULTS A total of 165 resections were performed; 130 patients (80%) were male. The median age was 66 years (range: 31-82 years). Eighty per cent had an adenocarcinoma. Sixty-four per cent of the tumours were T3/T4 and sixty-two per cent node positive. Forty patients (24%) had an involved circumferential resection margin (CRM). Five patients (3.0%) had no resection and a quarter (26%) developed morbidity of some form. There was one clinical anastomotic leak (0.6%) and three benign strictures requiring dilation (1.8%). In-hospital mortality was 3.0% (5 patients). Disease specific survival at one, two and five years was 77%, 42% and 36% respectively. Neither CRM involvement nor preoperative chemotherapy influenced survival significantly. No patient required intervention to disrupt the pylorus. CONCLUSIONS Excellent outcomes are achievable following open transthoracic oesophagectomy without radical lymphadenectomy using a hand sewn gastro-oesophageal anastomosis and without disrupting the pylorus. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
