Novosti
Khirurgii
This journal is
indexed in Scopus









Year 2012 Vol. 20 No 3

ONCOLOGY

V.T. MALKEVICH, V.V. ZHARKOV, L.I. OSITROVA, V.P. KURCHIN, A.YU. BARANOV, I.A. ILYIN

NEW APPROACHES TO TREATMENT OF INTRAPLEURAL COMPLICATIONS IN ESOPHAGEAL CANCER SURGERY

SE N.N.Alexandrov Republican Scientific Practical Center of Oncology and Radiology, Minsk
The Republic of Belarus

Objectives. To work out and introduce in the clinical practice a new treatment method of the intrapleural complications caused by anastomosis sutures failure and/or esophagotransplant necrosis at surgical treatment of the esophageal cancer.
Methods. The paper presents the surgical treatment experience of 59 patients on the basis of the thoracic department of N.N.Alexandrov Republican scientific practical center of oncology and radiology, in whom, after surgical treatment for esophageal cancer, intrapleural complications developed: esophageal anastomotic sutures failure was diagnosed in 17 and esophagotransplant necrosis in 42 patients.
Results. The conservative principle was used in 22 patients (the 1 group) with saving of the esophagogastric anastomosis; and 37 patients (the 2 group) were treated by active surgical tactics based on the disconnecting surgery with the resection of the proximal segment of gastric stem with the esophageal anastomotic segment and esophagostomy, gastro- or jejunostomy formation. In 6 patients from the 2 group, treatment of intrapleural complications was carried out using a new method by anastomotic esophageal segment and proximal gastric area apparatus resection within healthy tissue boundaries with the leaving of the resected stump in the posterior mediastinum, the formation of the cervical end esophagostomy in the left supraclavicular area and the suspended probe jejunostomy in the left mesogaster.
Conclusions. It was established that the optimal treatment method of esophagotransplant necrosis and/or esophageal anastomosis sutures failure was the active surgical tactics aimed to disconnect the alimentary tract continuity, allowing to reduce postoperative mortality and to provide the potential long-term survival rates for this group of patients by performing the reconstructive surgery.

Keywords: esophageal cancer, intrapleural complications, esophagotransplant necrosis, esophageal anastomosis sutures failure, disconnecting surgery
p. 74 80 of the original issue
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Address for correspondence:
223040, Respublika Belarus', Minskaia obl., Minskii raion, pos. Lesnoi 2, RNPTs onkologii i meditsinskoi radiologii im. N.N. Aleksandrova, otdel torakal'noi onkopatologii,
e-mail: malkvt@mail.ru,
Mal'kevich Viktor Tikhonovich
Information about the authors:
Malkevich V.T., Candidate of Medical Sciences, Senior Research Fellow, Department of Thoracic Cancer Pathology of the RSPC of Oncology and Medical Radiology named after N. N. Alexandrov.
Zharkov V.V., Doctor of Medical Sciences, Professor, Chief Research Fellow, Department of Thoracic Cancer Pathology of the RSPC of Oncology and Medical Radiology named after N. N. Alexandrov.
Ositrova L.I., Candidate of Medical Sciences, Oncologist-Surgeon of the Oncological Thoracic Department 1 of the RSPC of Oncology and Medical Radiology named after N. N. Alexandrov.
Kurchin V.P., Doctor of Medical Sciences, Head of the Department of Thoracic Cancer Pathology of the RSPC of Oncology and Medical Radiology named after N. N. Alexandrov.
Baranov A.Yu., Head of the Oncological Thoracic Department 1 of the RSPC of Oncology and Medical Radiology named after N. N. Alexandrov.
Ilyin I.A., a Clinical Resident of the RSPC of Oncology and Medical Radiology named after N. N. Alexandrov.
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