Cancer esophagus: 7 years experience in Assiut University Hospitals

ABSTRACT

This work represents our experience in 139 patients with proved cancer Esophagus. They were classified into two groups Group [I] Including 74patients who were managed in the period from April 1984 to December 1986. This period represented our early experience in dealing with such cases. Esophageal resection and Esophagogastric anastomosis were performed in 46 patients and Esophagogastric by pass operation in 4 cases. The anastomosis was done manually in 24 patients and by stapler in 26 patients. Two stapling devices were used [EEA in 12 and ILS in 14]. Leakage was a complication in 36% of the manual anastomosis and 15% of stapler type. Palliative procedures done for the inoperable cases were either esophageal intubation [14 patients] or gastrostomy in 3 patients. Group [II] Included 65 patients who were managed in the peroid from January 1987 to October 1991, During this period we modified our technique in anastomosis to avoid the anastomotic leakage and gastric perforation that were encountered in the first group. Esophageal resection and Esophago gastric anastomosis were performed in 31 patients and esophageal resecetion with total gastrectomy was undertaken in other 2 cases. The anastomosis was sewn manually in 29 patients and using ILS device in the remaining 4 cases. The incidence of leakage has been decreased markedly in this group but still there is substantial mortality attributed to other causes than leakage. Palliative procedures were resorted to in 30 patients, palliative intubation was used in 18 cases and substernal gastric pedicle tube by pass in 12 cases. The other 2 cases who had an upper 1/3 carcinoma were refered to deep x-ray therapy