From January 1984 to December 1991. One hundred sixty five patients with carcinoma of the esophagus were treated surgically at the department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital.
Among then, hospital records were availabele in 121 patients and were included in this study.
There were 115 men and 6 women, with ages ranging from 40 years to 79 years (mean age of 59.2 years).
The most frequent preoperative symptoms included dysphagia (72.7%), weight loss (60.3%), chest pain or discomfort (14.9%), general malaise (13.2%).
All were treated surgically: 100 patients were managed by curative or palliative resection with reconstruction, and 6 by palliative bypass surgery. In 15 patients, explorative thoracotomy or laparotomy was only done due to unresectability.
(operability:
87.6%, resectability: 82.6%).
All specimens (those from resectable 100 cases) were sent to pathology, and histopathologic examinations were done; squamous cell carcinomas were found in 95 cases, adenocarcinoma in 1. Adenosquamous carcinomas were found in 3, and malignant
melanoma in
1.
Postoperative complications occurred in 34 cases; anastomotic site leakage (10), which was followed by empyema in 9 of them, wound problem (7), hepatic failure (6), pneumonia (3), post-operative bleeding (3), chylothorax (2), post-operative
stricture
(2), sepsis (1), and tracheobronchial fistula (1).
Hospital deaths were in 6 cases (Hospital mortality: 5.0%).
During the follow up period, 26 patients were proven to be recurrence of cancer locally or distantly.
The one, two, and five-year actuarial survival rates were 71.3±4.5%, 57.4±5.8%, 34.7±8.9%, respectively.
The data from this study suggested that esophagectomy with reconstruction of gastrointestinal tract could be performed with a low operative mortality and a few serious postoperative complications and achieved reasonable long term palliation for
carcinoma of the esophagus.
|