Resultados de la esofaguectomía en 53 pacientes con adenocarcinoma del esófago y Barrett extenso

Abstract

Results of esophagectomy among patients with esophageal cancer and Barrett esophagusBackground: The incidence of esophageal carcinoma has increased notoriously worldwide. Aim: To assess clinical features, immediate surgical results and long term survival of patients with esophageal carcinoma and Barrett esophagus. Material and Methods: Retrospective review of medical records of all patients operated for esophageal carcinoma, between 1996 y 2011. Results: The records of 53 patients aged 58 ± 9 years (45 males) were analyzed. The number of operated patients increased from 7 in the period 1968-1983 to 31 in the period 2004-2011. Peritoneal metastases were found in two patients, precluding a resection. Video assisted trans-hiatal approach was the most commonly used technique followed by minimally invasive thoracoscopic and laparoscopic surgery. Transit reconstruction was performed ascending the stomach to the neck in 90% of patients. The average length of Barrett esophagus was 7.4 cm and the mean number of excised lymph nodes was 19. Ten patients had an incipient cancer and their five years survival was 80%. The survival of those with tumors involving the muscular layer and those with transmural cancer was 25 and 5%, respectively. Conclusions: There is an increase in the incidence of esophageal cancer in the last 10 years. The survival after surgery is highly dependent on the invasiveness of the tumor.

Acalasia Y Su Relación Con El Cáncer Esofágico

“…El epitelio escamoso puede malignizarse por múltiples causas a un carcinoma de células escamosas o epidermoide. Representa cerca de un 90% de los casos de cáncer esofágico en Asia Oriental, pero en el Occidente y en especial en Chile, sólo representa el 50%, por un importante aumento del adenocarcinoma esofágico 12 , Su incidencia en Chile es de 4 x 100.000 habitantes 13 . Se postula una transformación neoplásica de las células epidermoides del esófago aperistáltico debido a la constante irritación de la mucosa por factores químicos y por mutaciones genéticas asociadas a la acalasia 14 .…”

Disección Endoscópica Submucosa Para El Tratamiento Del Cáncer Esofágico

“…La esofagectomía con disección ganglionar constituye el estándar de tratamiento en pacientes con enfermedad localizada 5 . Es una de las cirugías electivas con mayor mortalidad perioperatoria, alcanzando un 13% en centros con bajo volumen de casos y alrededor de 5% en aquellos de alto volumen [5][6][7][8] . La morbilidad reportada varía entre un 50%-75%, siendo las principales complicaciones las respiratorias, que incluso superan el 30% en cirugía abierta [6][7][8][9] .…”