Radical en bloc esophageal – gastric resection

By | March 22, 2012

Radical en bloc esophageal – gastric resection is described by Logan in 1963. Skinner reported in 1983, the entire purpose of esophageal gastrectomy wide excision of adjacent tissue around the esophagus and stomach with more radical lymph node dissection, thus reducing the postoperative recurrence and metastasis and prolong survival time. Oullarnd reported lymph node metastasis, postoperative 5-year survival rate of 32%. Skinner reports, Tl of the patients and less than 5 patients with T2, lymph node metastasis, the overall 5-year survival rate after surgery was 75%.
Radical en bloc esophageal – gastric resection (1) indications. For I on, ITa period, ITb of patients, III because of the patient has lost the opportunity to cure, it does not meet the indications for radical surgery. Some researchers think: As I esophageal mucosa of patients with tumors confined, lymph node metastasis less than 5%. The radical en bloc resection of the patient trauma, surgery requires certain conditions, it is the indication of radical en bloc resection should be ITa period, ITb of patients.
Radical en bloc esophageal – gastric resection (2) surgical path. According to the tumor may be, in general, lower and cardiac incision is preserved through left a path through the right chest of a middle abdominal incision esophagus, upper esophageal cancer by a neck, right chest, three abdominal incision.
Radical en bloc esophageal – gastric resection (3) resection. Resection is the removal of the typical distance from the edge of the tumor normal esophageal 10cm long, including the azygos vein, thoracic duct, the esophagus of a mediastinal pleura, some patients also include the pericardium and the right posterior intercostal vessels. For lymph node resection controversial, some scholars believe that the lower esophageal cancer, only two doors and responsibilities in regional lymph nodes removed; Some scholars believe that, due to the lower 10% of esophageal cancer with cervical lymph node metastasis, therefore, more worthy of the three regional lymph node dissection advocated.

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