ABSTRACT
The performance of extensive lymph node dissection+ in esophageal carcinoma is substantiated. From their own data the authors conclude that squamous cell carcinoma of the esophagus possesses high lymphatic metastatic activity and point to the statistically significant increase of the incidence of involvement of the superior perigastric lymph nodes in localization of the tumor in its infrathoracic part. At the same time, the frequency of affection of the mediastinal lymph collector does not depend on the localization of the tumor. The authors emphasize that extensive subsequent lymph node dissection+ of the mediastinum and upper part of the abdominal cavity should be an obligatory stage of an operative intervention in esophageal carcinoma.
Subject(s)
Carcinoma, Squamous Cell/surgery , Esophageal Neoplasms/surgery , Esophagus/surgery , Lymph Node Excision/methods , Lymph Nodes/surgery , Mediastinal Neoplasms/secondary , Neck Dissection/methods , Carcinoma, Squamous Cell/pathology , Esophageal Neoplasms/pathology , Esophagus/pathology , Humans , Lymph Nodes/pathology , Lymphatic Metastasis , Mediastinal Neoplasms/etiology , Mediastinal Neoplasms/surgery , Severity of Illness IndexABSTRACT
Acute respiratory failure (ARF) in the earliest postoperative period after radical surgery for esophageal cancer is characterized by staged development. Its severity is determined by the degree of ventilation-perfusion disorders and the accompanying diffusion disturbances. The following factors are considered to be ARF-provoking: postaggressive circulation centralization, predominant administration of crystalloid plasma substitutes, persistence of hypoproteinemia in the earliest postoperative period, as well as extended lymph dissection involving cardiopulmonary plexus located in the area of bifurcation. The latter factor is the peculiarity of surgery caused by oncological considerations, while three former factors should be taken into account during management of patients in the intra- and postoperative periods.
