[SURGICAL TREATMENT OF ESOPHAGEAL NEOPLASMS]
This report includes the experience of a surgical team from "Edgardo Rebagliati" Hospital, the Social Security Hospital in Lima, Peru. From 1987 to 1997 we carry out surgical management of epidermoid and glandular esophageal cancer having registered 74 cases. 52.7% of the cases had epidermoid cancer and 42.8% had adenocarcinoma. We had one case of primary melanoma and one case of primary lymphoma which were also subjected to esophagectomy. Almost all patients were in stages III and IV. Only one patient was considered to be in stage I, and one in stage II. These last ones have experienced more than 6 years of postoperatory survival. 67.4% of the patients showed tabaquism, alcoholism or both antecedents. In 50% of the cases the tumor was located in the lower third; in 45.9% it was located in the middle third, and in 4.05% in the upper third. 62.1 % of the patients were subjected to esophagectomy and gastrectomy of the upper third in block plus cervical esophagogastroplasty. 18.9% were subjected to total esophagogastrectomy and esophagocoloplasty, 14.8% were subjected to cervical esophagogastroplasty with gastric tube made with a major curvature and without esophagectomy. One patient was subjected to total pharyngothyroid esophagectomy with anastomosis at orofaringeal level due to pharyngoesophagic epidermoid cancer, including radical cervical dissection. The operative and perioperative mortality was of 4.05%, the morbidity was: 33.7% due to respiratory causes; 20.2% due to cervical fistula with spontaneous closure and 4.05% due to severe mediastinitis. Patients left the hospital at the 15th day average and began their oral feeding between the 10th and 14th day after the surgery. In all cases a progressive recovery of the nutritional level and the improve of life quality were achieved.
Manuel
M
Huamán Guerrero