Protocol of Surgical Treatment of Esophageal Tumor that Depends on Radiotherapy and Chemotherapy (original) (raw)

2019, Acta Scientific Medical Sciences

Malignant esophageal tumors are one of the most difficult diseases, because when they are noticed, they are already in advanced stage. Sometimes even radical surgical methods can not give desireable results. Results of surgical treatment are best in countries where screening program is included in routine diagnostics. Malignant esophageal tumor takes fourth place out of all tumors of digestive tract, and average age of diseased are between 55.-65. years. First aim of this study is to analize localization of esophageal tumors, pathohistological representation, operating techniques and complications. Second aim of this study is to show relation between surgical treatment and preoperative radiotherapy and chemotherapy. This retrospective study included 13 patients with pathohistology of esophageal tumor who were on Clinic for abdominal surgery KCUS during two years. All patients had different surgical treatments which depended on stage which was find during surgery. Patients were analyzed based on age, sex, localization of esophageal tumor, and stage of tumor. Analysis of 13 patients included resectional methods, pathohistology and preoperative oncological treatment. Results were different and were corelated with neoadjuvant oncological treatment. Radical surgery had 11 patients that included esophagectomy and esophagoplasty with removal of regional lymphonodes. Esophagogastroplasty was tretment for 6 patients. Becuase of inadequate nutrition or inoperable tumors 6 patients had gastrostomy. Implatation of Haering dentures was included as palliative surgery in 2 patinets. The most of esophageal tumors were located in the lower third (53,84%), and the leaset of esophageal tumors were located in the upper third (15,83%). Pathohistology analysis of esophageal tumors showed that tumors were planocellular carcinoma (67%) and adenocarcinoma (23%). In most cases radical surgery treatment was required. Tumors of lower third esophagus are most numerous, and least numerous are in upper third. Planocellular carcinoma is the most often malignant tumor of esophagus. Radical surgical approach was used 84,6% patients and the rest patients 15,4% had palliative surgery. The most used techniques was gastroplasty which was the best and from palliative sugery was gastrostomy. Postoperative complications were present in 23,1% of cases. Reactions of tumor on chemotherapy and radiotherapy are different, sometimes even remission of malignant cell is possible. Even in that cases radical surgical approach remains the best method in every case after chemotherapy and radiotherapy.