Principles of Surgical Treatment for Carcinoma of the Esophagus

Abstract

Extensive lymph node dissections in the posterior mediastinum and abdomen were performed during resections of esophageal carcinomas. Analysis of lymph nodes demonstrated a widespread distribution of positive lymph nodes regardless of the location of the tumor. The distribution of positive lymph nodes was noticed in the area between the superior mediastinum and the celiac region. The studies were also made on the distribution of positive lymph nodes in the superior gastric region, particularly in the region of the lesser curvature of the stomach. The following principles should be followed when carcinoma of the esophagus is surgically treated. 1) Lymph node dissection of the whole length of the posterior mediastinum, superior gastric region, and celiac region must be performed. 2) Total thoracic and abdominal esophagectomy with resection of the proximal lesser curvature and cardia, including the first to fourth branches, and preferably the fifth branch of the left gastric artery, is mandatory in order to remove possible lymphatic and intramural spread of tumors. 3) Satisfactory esophageal replacement in one stage must follow. Of the Toranomon Hospital, 210 underwent resections and reconstructions, for a resectability rate of 59.3%. The operative mortality rate was 1.4% and the overall five-year survival rate was 34.6%.

Combined chemotherapy and radiotherapy followed by surgery in the treatment of patients with squamous cell carcinoma of the esophagus

“…By combining chemotherapy and radiotherapy prior to surgery, the outcome for patients with Stage I-III tumors seems to be improved, with a mean survival rate of 26.5% at 2 years 6,8,34,[37][38][39][40] and a low (Ͻ 5%) hospital mortality rate. 24,[41][42][43] Walsh et al 44 showed clearly that multimodal therapy is superior to surgery alone for patients with esophageal adenocarcinoma, with a 3-year survival rate of 32% versus 6%. This is consistent with our finding of a 5-year survival rate of 33% and a DFS rate of 29%.…”

Laparoscopic management of incarcerated diaphragmatic hernia 6 months post mini-invasive esophagectomy and retrosternal gastroplasty

“…С этой целью, кроме ушивания пищеводного отверстия диафраг-мы до размеров кондуита, используется укрепление нерассасывающимися материалами, например по-липропиленовой сеткой или химически-попереч-носвязанным коллагеновым матриксом [10][11][12]. В нашем наблюдении были использованы нерасса-сывающиеся отдельные узловые швы плетеной ни-тью, а также укрепление линии швов биологической сеткой, что снизило риск присутствия инородного синтетического материала в потенциально инфици-рованной полости.…”

Decreased expression of claudin-1 is correlated with recurrence status in esophageal squamous cell carcinoma

“…Many cases are advanced tumors with lymph node metastases at the time of diagnosis because it is difficult to detect in early stage (5). Clinicopathological features such as depth of invasion and lymph node status have been associated with prognosis of esophageal cancer (1,18). Staging of the disease is the most crucial parameter for predicting survival and recurrence (11).…”