Prophylaxis of complications in operations for cancer of middle and lower thirds of the esophagus

Keywords: esophageal cancer; esophageal resection; intrapleural esophago-gastric anastomosis; insufficiency of esophago-gastric anastomosis

Abstract

Objective. Improvement of the surgical treatment results in esophageal cancer.

Маterials and methods. Results of surgical treatment of 43 patients, having cancer of middle and lower thirds of the esophagus, were analyzed. Lewis operation was performed in 38 patients, and Garlock operation – in 5. Circular suture stapler with second row of a П-like manual sutures was applied in 28 patients. In 15 patients anastomosis was formatted, using hand-sewn two-row suture. The method of anastomosing choice had depended upon local and general factors: the tumor localization, the esophageal wall changes in anastomotic site, degree of the water-electrolyte disorders, the protein balance, concurrent pathology. Prophylaxis of postoperative morbidity consisted of preoperative correction of laboratory indices, treatment of concurrent pathology, choice of the anastomosis formation method, postoperative intensive therapy.

Results. Postoperative complications had occurred in 1 (2.3%) patient. Mostly frequent postoperative complication after resection for esophageal cancer constitute insufficiency of esophago-gastric anastomosis, which occurs under impact of general and local factors. General factors: disorders of the blood circulation, caused by cardiac insufficiency, hypoxia due to pulmonary insufficiency, coagulopathy, disorders of the protein and water-electrolyte metabolism. Reduction of influence of general factors on the postoperative morbidity occurrence was achieved using the intensive preoperative preparation conduction.

Conclusion. The postoperative morbidity prevention turns effective while its accomplishment on all stages of treatment: during preoperative preparation, intraoperatively and postoperatively.

Author Biographies

О. М. Коzachuk, Regional Clinical Hospital

Olexandr Kozachuk - thoracic surgeon, Communal institution Kiev region council «Kiev regional clinical hospital» department of thoracic surgery, Kiev, str. Baggovutivska 1
Phone: (044) 483-71-20, Mobile: 067-406-24-22
e-mail: kozachuka61@gmail.com,
ORCID ID: https://orcid.org/0000-0002-6200-327X

І. V. Shveikin, Kyiv Regional Clinical Hospital

Igor Shveikin - thoracic surgeon, Communal institution Kiev region council «Kiev regional clinical hospital» department of thoracic surgery, Kiev, str. Baggovutivska 1,
Phone: (044) 483-71-20,
e-mail: torakalne21@ukr.net,
ORCID ID: https://orcid.org/0000-0002-1413-7302

А. V. Kоminko, Kyiv Regional Clinical Hospital

Anatoliy Kominko - thoracic surgeon, Communal institution Kiev region council «Kiev regional clinical hospital» department of thoracic surgery, Kiev, str. Baggovutivska 1,
Phone: (044) 483-71-20,
e-mail: avkominko@meta.ua,
ORCID ID: https://orcid.org/0000-0001-5496-0064

S. І. Оrgan, Kyiv Regional Clinical Hospital

Sergii Organ - thoracic surgeon, Communal institution Kiev region council «Kiev regional clinical hospital» department of thoracic surgery, Kiev, str. Baggovutivska 1,
Phone: (044) 483-71-20,
e-mail: serhiiorhan@gmail.com,
ORCID ID: https://orcid.org/0000-0002-6353-8161

А. М. Kаrnuta, Kyiv Regional Clinical Hospital

Andrey Karnuta - thoracic surgeon, Communal institution Kiev region council «Kiev regional clinical hospital» department of thoracic surgery, Kiev, str. Baggovutivska 1,
Phone: (044) 483-71-20,
e-mail: karnuta@ukr.net,
ORCID ID: https://orcid.org/0000-0002-6980-0781

S. М. Маrtseniuk, Kyiv Regional Clinical Hospital

Sergii Martseniuk - thoracic surgeon, Communal institution Kiev region council «Kiev regional clinical hospital» department of thoracic surgery, Kiev, str. Baggovutivska 1,
Phone: (044) 483-71-20, Mobile: 096-172-16-63
e-mail: msmmsm@bigmir.net,
ORCID ID: https://orcid.org/0000-0001-7609-2755

References

1. Kavajkin AG, Chichevatov DA. Puti uluchshenija neposredstvennyh rezul'tatov vnutriplevral'noj jezofagoplastiki pri rake pishhevoda i gastrojezofageal'nom rake. Zhurnal Sovremennye problemy nauki i obrazovanija scholar. 2012;3:8. [In Russian].
2. Ursol GN. Sposoby hirurgicheskogo lechenija raka pishhevoda. Scintific Jornal «Science Rise. 2015;3/4(8):19 – 26. [In Ukrainian].
3. Kononec PV, Kanner DYu, Shveĭkin AO. Torakoskopicheskaja rezekcija pishhevoda pri rake. Klinicheskya i jeksperimentalnaya khirurgiya. Zhurn. im. akad. B.V. Petrovskogo. 2015;(4):28 - 34. [In Russian].
4. Mal'kevich VT, Bogushevich EV, Ositrova LI. Rentgenodiagnostika vnutriplevral'nyh oslozhnenij posle hirurgicheskogo lechenija po povodu raka pishhevoda i kardii. Novosti hirurgii. 2011;19(6):95 – 100.
Published
2016-07-20
How to Cite
КоzachukО. М., ShveikinІ. V., KоminkoА. V., ОrganS. І., KаrnutaА. М., & МаrtseniukS. М. (2016). Prophylaxis of complications in operations for cancer of middle and lower thirds of the esophagus. Klinicheskaia Khirurgiia, 85(7), 13-15. https://doi.org/10.26779/2522-1396.2018.07.13
Section
General Problems of Surgery