Surgical treatment of esophageal cancer contraindications

By | March 23, 2012

Surgical treatment of esophageal cancer contraindications tracheobronchial involvement. Ellis considered when tracheal involvement, especially when there tracheoesophageal thin, is an absolute contraindication. This view is accepted by everyone. Bronchoscopy is to determine whether the involvement of the trachea and the necessary high accuracy of the inspection. A membranous tracheal bronchial edema, a slight bulge is often the tracheobronchial wall involvement, the tumor has not completely removed the evidence. CT scan to determine whether the involvement of tracheobronchial meaningful, but the sensitivity is not high, mainly for the retraction or displacement of the posterior wall of the trachea, there is raised to the tracheobronchial tumor cavity, and occasionally found in esophageal tracheal thin. China in recent years, some scholars also removed by resection of esophageal involvement in lung tumor, trachea membranous way, in order to improve the patient's quality of life.
Esophageal cancer surgical treatment of thoracic aortic involvement contraindication. Although aortic involvement is a contraindication to esophageal resection, but the real involvement of the aorta to rare cases of inoperable. Picus that the CT scan of thoracic aortic invasion criteria: normal aortic cross section was 360. Due to ring, if the thoracic aorta and the tumor is larger than the contact angle of 90 , the thoracic aorta involvement is no doubt that; if the contact angle between the two is less than 45 , the thoracic aorta that is not involved; if the contact angle 45. And 90. Between the thoracic aorta is difficult to judge whether the involvement.
Surgical treatment of esophageal contraindication extensive abdominal lymph node metastasis in dry areas. For esophageal cancer, if the CT scan showed extensive lymph node metastasis in the area have, more shall be considered as surgical contraindications.
Surgical treatment of esophageal contraindication cancer violations range, and perforation have been obvious signs of foreign invasion, and distant metastasis in cancer patients have been, should not consider surgical treatment, should be listed as a contraindication for surgical treatment .
heart function. Ischemic cardiomyopathy associated with frequent attacks of angina, myocardial infarction within 6 months, ECG showed ST-T changes associated with II, field level or multi-room source in a room block, polymorphic ventricular premature beats were three couplets or more, that multiple sources of ventricular arrhythmias, including frequent premature ventricular contractions, ventricular tachycardia, ventricular fibrillation in patients with esophageal cancer surgery should be considered an absolute contraindication.
lung function. Severe chronic obstructive pulmonary disease in elderly patients, postoperative respiratory complications, the risk is high. Normal pulmonary function tests are: maximum voluntary ventilation (maximal voluntary ventila-tion, MVV) for the predictive value of 60% postoperative mortality rate below 32%, 60% for the predictive value of only 10% were postoperative mortality, the majority of The researchers believe that 50% of MVV in the risk of a sharp increase below the first gas expiratory volume in Is (forced expciratory volume in 1 second, FEV1) should belong to the following thoracotomy in the 1.0L contraindications; maximum mid-expiratory flow (maximal mid- expiratory flow, MMEF) normal for the 3 – 5L / s, at 40% below normal after the high incidence of pulmonary complications.
Surgical treatment of esophageal contraindication liver function. Chronic active hepatitis is a relatively simple method for long-term observation of ALT changes, if there is abnormal aminotransferase, 100U from 100U to rise to above the following can be viewed as active hepatitis, ALT increased to more than 300U should be regarded as acute diseases, absolute contraindication. However, there are still some practical difficulties in determining the "critical mass" of liver failure, the liver can not tolerate surgery is difficult to determine the function of the cutoff values trauma. Richelme that the Child classification of liver function to determine the status of a certain reference value: ChildA can tolerate surgery; ChildB surgery is considered a contraindication. If patients with esophageal cancer associated with ascites or decompensated liver function should also be considered as taboo surgery.

Leave a Reply

Your email address will not be published. Required fields are marked *