Novosti
Khirurgii

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Year 2018 Vol. 26 No 3

ONCOLOGY

I.A. ILYIN

RESULTS OF THREE-STAGE ESOPHAGECTOMY WITH ONE-PHASE ESOPHAGOCOLONOPLASTY IN ESOPHAGEAL AND GASTROESOPHAGEAL JUNCTION CARCINOMAS TREATMENT

N.N. Alexandrov National Cancer Centre of Belarus, Minsk,
The Republic of Belarus

Objective. To evaluate the results of three-stage esophagectomy with one-phase esophagocolonoplasty in surgical treatment of esophageal and gastroesophageal junction carcinomas depending on graft translocation route to the neck.
Methods. Åsophagectomy with one-phase esophagocolonoplasty was performed in 30 patients. Depending on the graft translocation route to the neck, two groups of patients were formed: the 1st group — with retrosternal route (n=13) and the 2nd — with posterior mediastinal one (n=17). The groups did not differ in morphology, pT and pN, stages, age, body mass index and sex.
Results. Time of procedures in the 1st and 2nd groups was 435.0 (390.0, 477.5) and 425.0 (352.5, 467.5) minutes (p=0.691), blood loss volume — 400 (325.0, 525.0) and 500.0 (475.0, 725.0) ml (p=0.020), in-hospital stay — 30.0 (23.0, 36.0) and 32.0 (20.0, 57.5) days respectively (p=0.900). Esophago-colonic anastomotic leakage and graft proximal necrosis was detected by physical examination and X-rays on 7th day after the procedure. Anastomotic leakage in the 1st and 2nd groups developed in 2 (15.4%) and 2 (11.8%) cases (p=0.776), graft necrosis — in 1 (7.7%) and 1 (5.9% %) (p=0.846). Late anastomotic stricture of the esophageal-colonic anastomosis, determined endoscopically 3 months after the procedure developed in 2 (15.4%) and 1 (5.9%) patients respectively (p=0.398). Hospital and 30-day mortality did not differ — 1 (7.7%) and 1 (5.9%) (p=0.846); overall 5-year survival made up 18.6 and 20.6% respectively (plogrank=0.804).
Conclusions. Esophagectomy with one-stage esophageal replacement by primary coloplasty in surgical treatment of esophageal and gastroesophageal junction carcinomas regardless of graft translocation route to the neck is a complex procedure that allows achieving long-term treatment results comparable to those in the standard procedures.

Keywords: esophageal carcinoma, gastroesophageal junction carcinoma, three-stage esophagectomy, one-phase esophageal replacement by primary coloplasty, graft translocation route, posterior mediastinal route, retrosternal route
p. 340-347 of the original issue
References
  1. Reslinger V, Tranchart H, D’Annunzio E, Poghosyan T, Quero L, Munoz-Bongrand N, Corte H, Sarfati E, Cattan P, Chirica M. Esophageal reconstruction by colon interposition after esophagectomy for cancer analysis of current indications, operative outcomes, and long-term survival. J Surg Oncol. 2016 Feb; 113(2):159-64. doi: 10.1002/jso.24118
  2. Awsakulsutthi S, Havanond C. A retrospective study of anastomotic leakage between patients with and without vascular enhancement of esophageal reconstructions with colon interposition: Thammasat University Hospital experience. Asian J Surg. 2015 Jul;38(3):145-49. doi: 10.1016/j.asjsur.2015.01.005
  3. Chakiev AM. Vozmozhnost’ primeneniia mikrokhirurgicheskikh sosudistykh anastomozov pri ezofagoplastike. Vestn KRSU. 2008;8(5):26-28. (in Russ.)
  4. Vorobei AV, Chepik DA, Vizhinis EI, Lur’e VN. Klinicheskoe obosnovanie odnoetapnoi zagrudinnoi ezofagokoloplastiki v lechenii bol’nykh s posleozhegovoi rubtsovoi strikturoi pishchevoda. Meditsina. 2009;(4):52-56. (in Russ.)
  5. Uchiyama H, Shirabe K, Morita M, Kakeji Y, Taketomi A, Soejima Y, Yoshizumi T, Ikegami T, Harada N, Kayashima H, Morita K, Maehara Y. Expanding the applications of microvascular surgical techniques to digestive surgeries: a technical review. Surg Today. 2012 Jan;42(2):111-20. doi: 10.1007/s00595-011-0032-5
  6. Averin VI, Podgaiskii VN, Nesteruk LN, Grinevich IuM, Ryliuk AF. Pervyi opyt revaskuliarizatsii transplantata pri plastike pishchevoda u detei v nestandartnykh situatsiiakh. Novosti Khirurgii. 2012;20(1):80-84. http://www.surgery.by/pdf/full_text/2012_1_14_ft.pdf (in Russ.)
  7. Kesler KA, Pillai ST, Birdas TJ, Rieger KM, Okereke IC, Ceppa D, Socas J, Starnes SL. «Supercharged» isoperistaltic colon interposition for long-segment esophageal reconstruction. Ann Thorac Surg. 2013 Apr;95(4):1162-68; discussion 1168-9. doi: 10.1016/j.athoracsur.2013.01.006
  8. Bakshi A, Sugarbaker DJ, Burt BM. Alternative conduits for esophageal replacement. Ann Cardiothorac Surg. 2017 Mar;6(2):137-43. doi: 10.21037/acs.2017.03.07
  9. Ilyin IA, Malkevich VT. Repeated and delayed esophagoplasty in esophageal and gastroesophageal cancer treatment. Vesti NAN Belarusi. Ser Med Nauk. 2016;(2):15-22. (in Russ.)
  10. Blackmon SH, Correa AM, Skoracki R, Chevray PM, Kim MP, Mehran RJ, Rice DC, Roth JA, Swisher SG, Vaporciyan AA, Yu P, Walsh GL, Hofstetter WL. Supercharged pedicled jejunal interposition for esophageal replacement: a 10-year experience. Ann Thorac Surg. 2012 Oct;94(4):1104-11; discussion 1111-13. doi: 10.1016/j.athoracsur.2012.05.123
  11. Chernousov AF, Khorobrykh TV, Chernousov FA, Vychuzhanin DV. Khirurgicheskoe lechenie raka kardii. Moscow, RF: Prakt Meditsina; 2016. 128 p. (in Russ.)
  12. Reslinger V, Tranchart H, D’Annunzio E, Poghosyan T, Quero L, Munoz-Bongrand N, Corte H, Sarfati E, Cattan P, Chirica M. Esophageal reconstruction by colon interposition after esophagectomy for cancer analysis of current indications, operative outcomes, and long-term survival. J Surg Oncol. 2016 Feb;113(2):159-64. doi: 10.1002/jso.24118
  13. Saeki H, Morita M, Harada N, Egashira A, Oki E, Uchiyama H, Ohga T, Kakeji Y, Sakaguchi Y, Maehara Y. Esophageal replacement by colon interposition with microvascular surgery for patients with thoracic esophageal cancer: the utility of superdrainage. Dis Esophagus. 2013 Jan;26(1):50-56. doi: 10.1111/j.1442-2050.2012.01327.x
  14. Ceroni M, Norero E, Henríquez JP, Viñuela E, Briceño E, Martínez C, Aguayo G, Araos F, González P, Díaz A, Caracci M. Total esophagogastrectomy plus extended lymphadenectomy with transverse colon interposition: a treatment for extensive esophagogastric junction cancer. World J Hepatol. 2015 Oct 8;7(22):2411-17. doi: 10.4254/wjh.v7.i22.2411
Address for correspondence:
223040, The Republic of Belarus,
Minsk region, Lesnoy village 2,
N.N. Alexandrov National Cancer
Centre of Belarus
Surgical Department,
Tel. office: 8 017 389 95 32,
e-mail: ileus@tut.by,
Ilya A. Ilyin
Information about the authors:
Ilyin Ilya A., PhD, Leading Researcher of the Surgical Department, N.N. Alexandrov National Cancer Centre of Belarus Minsk, Republic of Belarus.
http://orcid.org/0000-0002-5314-7618
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