RESUMEN
It was evaluated mini-invasive endovideosurgical technologies using in complex treatment of esophagus cancer. The investigation included 28 patients with thoracic esophagus cancer. Age of patients operated in terms from April 2012 to December 2013 was from 42 to 74 years (mean 61.7 ± 8.7 years). Only surgical treatment was used in 10 patients. Neoadjuvant chemotherapy and radiotherapy were performed in 18 patients. Hybrid mini-invasive esophagectomy (laparoscopic stomach mobilization and right-side thoracotomy) were used in 14 cases. The frequency of postoperative complications was 35.5%. Mini-invasive endovideosurgical esophagectomy was done in 14 patients. The frequency of postoperative complications was 57.1%. There were not deaths. Our experience demonstrates good results of mini-invasive technologies using in treatment of patients with esophagus cancer. Endovideosurgical methods permit to perform adequate volume of surgery in case of oncological diseases.
Asunto(s)
Neoplasias Esofágicas/cirugía , Procedimientos Quirúrgicos Mínimamente Invasivos/métodos , Cirugía Asistida por Video/métodos , Adulto , Anciano , Neoplasias Esofágicas/tratamiento farmacológico , Neoplasias Esofágicas/radioterapia , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Terapia Neoadyuvante , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
For treatment of cancer of the thoracic esophagus, the method of neoadjuvant chemoradiotherapy (CRT) with a use of intraluminal brachytherapy (BT) was performed. The study included 51 patients (mean age 56.9 ± 4.3 years). The length of the primary tumor up to 6 cm was determined in 18 patients, more than 6 cm--33 patients. CRT included three BT sessions (7Gy X 3; q7d) and two cycles of chemotherapy (PF; q28d). After CRT in 30 (62.4%) patients there was marked a complete or partial radiological tumor regression. In 40-45 days after CRT surgery performed. Subtotal resection of esophagus of the Lewis type was performed in 29 cases, transtracheal ex- tirpation of the esophagus--in 2, minimally invasive esopha- gectomy--in 17 cases. Postoperative complications occurred in 22 (44%) patients; one patient died (2%). In 11 (23%) patients morphological investigation revealed a complete regression of the primary tumor. Thus, a use of intraluminal BT in combination with chemotherapy in many cases promoted reducing the size of the primary tumor of the esophagus, which was an effective factor in improving surgical results.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Braquiterapia , Neoplasias Esofágicas/radioterapia , Esofagectomía , Terapia Neoadyuvante/métodos , Adulto , Anciano , Anciano de 80 o más Años , Quimioradioterapia Adyuvante , Neoplasias Esofágicas/patología , Neoplasias Esofágicas/terapia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Tiempo , Resultado del TratamientoRESUMEN
The article presents an analysis of 34.903 esophagoscopy results performed for population of Leningrad region at the period from 2007 to 2013. A prevalence of erosive esophagitis was 4.9%, peptic strictures--0.18%, columnar-celled metaplasias--1.43% and esophageal adenocarcinoma--0.645%. The data obtained showed a high prevalence of GERD-associated syndromes with injury of mucous coat of esophagus in the local population of Russians.
Asunto(s)
Enfermedades del Esófago , Esofagoscopía/estadística & datos numéricos , Esófago/patología , Reflujo Gastroesofágico , Adulto , Enfermedades del Esófago/diagnóstico , Enfermedades del Esófago/epidemiología , Enfermedades del Esófago/etiología , Femenino , Reflujo Gastroesofágico/complicaciones , Reflujo Gastroesofágico/epidemiología , Humanos , Masculino , Prevalencia , Federación de Rusia/epidemiologíaRESUMEN
An investigation included 33 patients with cancer of thoracal section of the esophagus at the age from 42 to 74 years old. A surgical method of treatment was applied as only one in 13 patients and methods of nonadjuvant chemoradiation therapy were used for 20 patients. A hybrid minimally invasive esophagectomy (laparoscopic mobilization of the stomach and right-side thoracotomy) was performed on 16 patients. The rate of postoperative complications consisted of 31%. The minimally invasive esophagectomy (performed by totally endovideosurgical approach) was carried out in 15 cases. Postoperative complications developed in 53% of follow-up patients. There weren't cases of lethality. The experience of minimally invasive methods indicated the satisfactory results of application of given methods in patient treatment of esophageal cancer. The use of endovideosurgical approaches allowed performing oncologically adequate volume of operative interventions.
Asunto(s)
Quimioterapia Adyuvante , Neoplasias Esofágicas , Esofagectomía , Complicaciones Posoperatorias , Radioterapia Adyuvante , Cirugía Torácica Asistida por Video , Adulto , Anciano , Terapia Combinada , Neoplasias Esofágicas/patología , Neoplasias Esofágicas/cirugía , Esofagectomía/efectos adversos , Esofagectomía/métodos , Femenino , Humanos , Laparoscopía/métodos , Tiempo de Internación , Masculino , Persona de Mediana Edad , Procedimientos Quirúrgicos Mínimamente Invasivos , Estadificación de Neoplasias , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/prevención & control , Estudios Retrospectivos , Federación de Rusia , Cirugía Torácica Asistida por Video/efectos adversos , Cirugía Torácica Asistida por Video/métodos , Resultado del TratamientoRESUMEN
The locally advanced cancer of thoracic esophagus was treated by induction chemo-irradiation therapy (IHRT) with intraluminal medium dose-rate brachytherapy (IMBT). From July 2009 to February 2012 twenty five patients (mean age 54.3 +/- 1.3 years) were included in the study. The length of the primary tumor was up to 6 cm in 10 pts and more than 6 cm in 15 pts. Induction therapy consisted of three IMBT sessions (7 Gy X 3; q7d) and two cycles of chemotherapy (PF; q28d), 26-31 days later the surgery was performed. Subtotal resection of the esophagus type of I Lewis was performed in 23 pts, transtracheal extirpation of the esophagus was performed in 2 pts.In all the cases 3F lymphodissection was performed. After IHRT in 15 of 25 pts. was obtained complete or partial response, in 10 of 25 pts was obtained disease stabilization. Perioperative complications occurred in 17 (68%) patients receiving conservative treatment, one patient (4%) died of treatment complications. In 6 cases (24%) morphology had shown the complete regression of primary tumor. Thus, the combination of intraluminal medium dose-rate brachytherapy and chemotherapy lead to reduction of primary tumor local spread and can be an efficient factor in improving the results of surgical treatment.