Salvage Esophagectomy in Advanced Esophageal Cancer

Aquino, José Luis Braga de; Leandro‐Merhi, Vânia Aparecida

doi:10.5772/intechopen.106857

Cited by 2 publications

(2 citation statements)

References 52 publications

(142 reference statements)

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“…Aquino and Leandro-Merhi [50] also demonstrated the validity of rescue esophagectomy. Out of 82 patients who underwent radiotherapy and chemotherapy after prior creation of the palliative gastric tube, 37 experienced tumor regression, with rescue esophagectomy performed by thoracotomy.…”

Section: Figurementioning

confidence: 90%

Advanced Esophageal Cancer Palliative Surgical Therapy Using Isoperistaltic Gastric Tube

Luis Braga De Aquino,

Aparecida Leandro-Merhi

2023

Palliative Care - Current Practice and Future Perspectives

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Although malignant neoplasms of the esophagus remain a very common disease, their diagnosis might often come late, which explains why 50% of patients require palliative treatment. The ideal scenario would be the performance of procedures that provided an adequate quality of life and satisfactorily restored swallowing. This chapter aims to describe the results of palliative methods, discussed with emphasis on the technique of the isoperistaltic greater curvature gastric tube (IGCGT). About 143 patients with unresectable squamous cell carcinoma of the esophagus (T4b) were evaluated at this facility. In the early postoperative evaluation, 64 patients (44.7%) presented systemic complications, with pulmonary infection being the most frequent; 51 patients (35.6%) presented local complications, with cervical esophagogastric anastomosis leak being the most frequent. Thirteen patients (9.1%) died as a result of postoperative complications. Out of 112 patients who were adequately followed up, 91 (81.2%) achieved good palliation with this procedure, as they had adequate restoration of swallowing function, with a median survival of 3 years in 63 patients (69.2%). With these results, it is possible to conclude that despite showing non-negligible morbidity, IGCGT can be performed quickly and safely, offering adequate palliation and survival rate.

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Section: Figurementioning

confidence: 90%

Advanced Esophageal Cancer Palliative Surgical Therapy Using Isoperistaltic Gastric Tube

Luis Braga De Aquino,

Aparecida Leandro-Merhi

2023

Palliative Care - Current Practice and Future Perspectives

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“…Some authors have also demonstrated in recent reports that in patients submitted to exclusive chemoradiation for palliative purposes, because they have advanced tumors, there is often regression of the local stage of the disease to the me-diastinal level, and thus it is possible to perform salvage esophagectomy. (3,4,13,48,49) AQUINO & LEANDRO-MERHI (50), also demonstrated the validity of salvage esophagectomy. Of the 82 patients who underwent radiotherapy and chemotherapy after the previous preparation of the palliative gastric tube, in 37 there was tumor regression, and rescue esophagectomy was performed by thoracotomy.…”

Section: Surgical Techniquesmentioning

confidence: 94%

Critical analysis of palliative surgical therapy for advanced thoracic esophageal cancer

Aquino,

Leandro -Merhi

2023

Global Health Trends and Perspectives in Health Sciences

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Although malignant neoplasm of the esophagus is a disease with a high incidence, its diagnosis is often still delayed. This fact combined with excessive weight loss due to dysphagia and the association with car-diopulmonary diseases resulting from excessive tobacco use, makes these patients have a difficult clinical control, which explains that more than 50% of them require palliative treatment. The ideal scenario would be to perform procedures that provide an adequate quality of life and with satisfactory rescue of swallowing, without the need for frequent hospitalizations and with a low rate of complications. Thus, this chapter aims to discredit the indications and results of palliative methods and especially shunt surgeries, discussing the technique of isoperistaltic gastric tube of great healing (GIT). In the Department of Surgery of Hospital PUC Campinas, 143 patients with unresectable esophageal squamous cell carcinoma (T4b) were studied, and all of them had clinical conditions to be submitted to GIT. In the early postoperative evaluation, 64p (44.7%) presented systemic complications, with pulmonary infection being the most frequent; 51p (35.6%) presented local complications, with dehiscence of the cervical esophagogastric anastomosis being the most frequent. 13p (9.1%) died due to postoperative complications. Of the 112 patients who were properly followed, 91 (81.2%) presented good palliation with this procedure, with adequate swallowing rescue. Chemoradiation was performed after the TGI in 82 patients, with a mean survival of 3 years in 63 patients (76.8%). With these results, it is possible to conclude that despite the postoperative morbidity not being negligible, the TGI can be performed safely, especially after the advent of mechanical suture, because it offers adequate palliation and survival. In addition, this procedure has the advantage of simultaneously providing good drainage of the esophagus and stomach, and thus potentially avoiding esophageal mucocele.

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Salvage Esophagectomy in Advanced Esophageal Cancer

Cited by 2 publications

References 52 publications

Advanced Esophageal Cancer Palliative Surgical Therapy Using Isoperistaltic Gastric Tube

Advanced Esophageal Cancer Palliative Surgical Therapy Using Isoperistaltic Gastric Tube

Critical analysis of palliative surgical therapy for advanced thoracic esophageal cancer

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