Clinical features of patients with cancer of thoracic esophagus and results of their surgical treatment

Fariz Jamalov
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Abstract

Esophageal cancer takes one of the first places in the structure of morbidity and mortality among malignant diseases. The development of anesthesiology and thoracic resuscitation provided the evolution of the surgical method. Resections of the esophagus with locally-disseminated and complicated forms of cancer have become possible. But even today, the long-term results of surgical treatment don’t satisfy clinicians. Often this is due to the dissemination of the tumor process in most patients at the time of treatment. For this purpose, an analysis of clinical material was carried out, including 89 patients with cancer of thoracic part of esophagus, who underwent reconstructive surgeries (extirpation of the thoracic part of esophagus with simultaneous retromediastinal plasty by stomach tube) in the surgical unit of Republican Clinical Hospital (RCH), n.a. academic M.A.Mir-Gasimov, Baku city. Interventions on the esophagus were performed either of two approaches – upper median laparotomy and left-sided cervicotomy (76 patients – 85,4%) or from three-with the addition of a right sided lateral thoracotomy in the fifth intercostal space (13 patients – 14,6%). There were no deaths due to surgical complications. The fundamental possibility and reasonableness of performing expanded radical interventions has been detected, taking into account the technical resectability of the tumor, which is especially important in working with a group of patients with “late” esophageal cancer criteria, such as the age of the patient, the size of the primary tumors, its local dissemination are not a contraindication to radical surgery.
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胸段食管癌患者的临床特点及手术治疗效果
食管癌在恶性疾病的发病率和死亡率结构中居首位。麻醉学和胸腔复苏的发展促进了手术方法的发展。局部播散和复杂形式的食道癌切除术已经成为可能。但即使在今天,手术治疗的长期效果也不能让临床医生满意。这通常是由于大多数患者在治疗时肿瘤的扩散过程。为此,我们对89例在巴库市M.A.Mir-Gasimov共和国临床医院(RCH)外科接受重建手术(切除胸段食道并同时经胃管后纵隔成形术)的胸段食管癌患者的临床资料进行了分析。对食道进行干预的方法有两种,一种是上正中剖腹手术,另一种是左侧颈切开术(76例患者- 85,4%),另一种是在第五肋间隙加右侧外侧开胸术(13例患者- 14.6%)。没有因手术并发症而死亡。考虑到肿瘤的技术可切除性,已经发现了进行扩大根治性干预的基本可能性和合理性,这在治疗“晚期”食管癌患者时尤其重要,如患者的年龄、原发肿瘤的大小、其局部扩散不是根治性手术的禁忌症。
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