The result of esophagoplasty with transverse colon: 63 cases

Background: esophagoplasty with transverse colon is often used for benign esophageal diseases. In esophageal cancer, esophagoplasty with transverse colon is applied when the colon can not be used or in gastric bypass surgery, without removing tumor. Objectives: to evaluate the results of esophagoplasty with transverse colon in the treatment of some disorders of esophagus. Subjectives and Method: a retrospective descriptive study was carried out on 63 patients who with transverse colon from January 1982 to December 2006, including 46 cases of esophageal scar due to chemical induced esophageal burn, 14 cases of esophageal cancer, 1 case of esophageal narrow after failed surgery of cardia contraction, 1 case of 2nd stage esophagoplasty after surgery for esophageal injury and 1 case due to failure of surgery for congenital esophageal atrophy. Results: No postoperative mortality. Early postoperative complications included: 17 cases of anastomotic leakage (26.9%). No cases of colon graft necrosis. Narrow anastomotis occurred in 7 cases (11.1%). Inflammation of colon graft due to esophageal reflux in 3 cases (4.8%). The mean survival time of 11 esophageal cancer patients who had esophagoplasty, not removing tumors was 4.6 months (3-7 months). Conclussion: esophagoplastic surgery with transverse colon did not cause postoperative mortality, the rate of neck anastomotic leakage was relatively high and this rate has declined in recent years. After the surgery, the most patients had good functional results.

Assessment of preliminary results of esophagectomy non thoracotomy for treatment of esophageal carcinoma

Background: Surgical treatment of esophageal carcinoma is a main operation in term of both technique and anesthesiology. The Orringer technique is one of the treatments. Objectives: 1. To describe clinical and subclinical characteristics of the middle and lower-third esophageal carcinoma. 2. To assess preliminary results of Orringer technique in treating of the middle and lower-third esophageal carcinoma. Subjects and method: A prospective, descriptive, following by time study was conducted in the patients who were diagnosed the middle and lower third esophageal carcinoma and operated by Orringer technique at the Department of Digestive Surgery in Viet Duc Hospital from January/2000 to June/2006. Results: The subclinical symptoms included difficult swallow (98.5%), anorexia and loss weight (98.5%), pain in chest (23.5%), loss of voice (2.9%) and bloody vomiting (5.9%). For clinical symptoms, 54/68 patients (79.4%) had lesions in lower-third esophageal, 14/68 (20.6%) had lesions in the middle-third esophageal. The average length of the lesions was 6.23\xb12.22cm (95% CI=5.69-6.77). The average operation time was 273.38 \xb154.56 minutes (range: 140-420), which is much faster than those in esophagectomy via thoracotomy: Lewis-Santy technique (324 minutes) and Akiyama technique (480 minutes). Both intraoperative and post-operative complications of Orringer technique were less than those of esophagectomy via thoracotomy. Conclusion: In this study, the clinical and subclinical strongest characteristics of the patients with the middle-third esophageal carcinoma appear in the advanced period (III period and IV period (over 70%)). Orringer technique had faster operation time, less complications and lower mortality than those of esophagectomy via thoracotomy.

The result of the esophageal plastic surgery with stomach tube

Background: In surgery for treating esophageal cancer, the esophageal plastic surgery with stomach tube is the operation of choice. However, there was high rate of anastomotic leakage in the esophageal plastic surgery with stomach tube with neck anastomosis. Objectives: to evaluate the result of the esophageal plastic surgery with isoperistaltic stomach tube. Subjectives and Method: a retrospective descriptive study was carried out on 94 patients with esophageal plastic surgery with isoperistaltic gastric tube at Department of Digestive Surgery, Viet Duc Hospital from January 1994 to June 2006. Results: among 94 patients of the study: 95 males (96.0%) and 4 women (4.0%). Mean age was 54.2 \ufffd?9.0. 98 cases was esophageal cancer (99%), 1 case of benign esophageal narrow due to scarring burns (1%). 31 cases of esophageal plasties with small stomach tube (31.3%), 68 cases of esophageal plasties with a large stomach tube (68.7%). The end-to-side anastomosis was done 95 times (96%), end-to-end anastomosis was done 4 times (4%). There were four deaths. 7 anastomotic leakage (7.1%), but not fatal. The postoperative complications included: 9 cases of respiratory complications (9.1%), 1 case of hypo-diaphragm abces (1%), 7 cases of incision infection (7%). 8 cases of anastomotic narrow (8.4%). 94 patients with normal stomach circulation (98.9%). 88 patients with normal eating (92.6%). Conlussions: the esophageal plastic surgery with isoperistaltic gastric tube was a safe method, with low rates of mortality, anastomotic leakage. Most patients with eating backed to normal.

Assessing quality of life of patients after esophageal cancer surgery

Background: Esophageal cancer is a disease with poor prognosis and the treatment is very difficult, requiring a combination of methods (surgery, radiotherapy and chemotherapy), in which surgery remains the most important method. However, quality of life of patients was still less interested in the studies. Objectives: to evaluate the quality of life of patients after esophageal cancer surgery in the Department of Digestive Surgery \ufffd?Viet Duc Hospital from 1994 to 2004. Subjectives and Method: a prospective study was conducted on 164 patients with esophageal cancer surgery at Viet Duc Hospital from January 1994 to June 2004. Results: mortality of the surgery was 5%, and rate of complications was 32.9%. 146 patients were closely followed up the quality of life after the surgery, showed: postoperative quality of life was good and moderate (80.1%). Quality of life of patients with radical surgery were better than that in patients without radical surgery, there was statistically significant with p <0.05. Mean postoperative survival time was 24.2 \xb1 2.3 months. Conclussions: surgery of esophageal cancer improved quality of life of patients. Radical features of surgery significantly influenced the quality of life of patients after surgery.

Lewis surgery in treatment of the lower two-thirds of the esophagus cancer

Background: Lewis surgery has been applied in the Department of Digestive Surgery, Viet-Duc hospital since 1991 and became routine surgery in the treatment of the lower two-thirds of the esophagus cancer. Objective: To present Lewis technique and results of operation in treating the lower two-thirds of the esophagus cancer. Subjects and methods: The study was carried out on 90 patients (86 men and 4 women) with the lower two-thirds of the esophagus cancer operated by the Lewis\u2019s technique. The average age of these patients was 52.3 \xb1 9.2. \r\n', u'Results: Disease stages: stage I: 2 cases (2.2%), stage IIA: 23 cases (25.6%), stage IIA: 23 cases (25.6%), stage IIB: 10 cases (11.1%), stage III: 42 cases (46.7%), stage IV: 13 cases (14.4%). There were three cases of postoperative death (5.6%). 34 cases had surgical complications or complications after surgery. The average survival time of patients after surgery was 23.8 months \xb1 2.8. Postoperative survival time of 1 year, 2 years, 3 years, 5 years was 58.2%, 39.2%, 23.4% and 12.0% respectively.\r\n', u'Conclusion: Mortality and postoperative complications of the surgery were low. So it should be selected for the treatment of the lower two-thirds of the esophagus cancer. The surgery helped 96.5% of patients to eat normally again. 5-year survival time after surgery was low because of diagnosis and surgery in late stages\r\n', u'\r\n', u'

Survival duration and prognosis factors after operation of esophageal cancer

Review of 84 patients with esophagus cancer operated from 1994 to 2000 by different techniques of esophagectomy was presented. 77 patients alived after operation were followed up to for survival and 12 prognosis factors were referred to this study. Survival time was calculated as 57.3%, 2 years survival 34.3%, 3 years survival 24.2%, and 5 years survival was 10.2%. By single analysis method, 5 factors having affected significantly to survival time were palliative or curative operation, the degree of differentiation of the tumour, ganglion metastasis and the TNM staging (p<0.05).