title: Treatment results of two-stage operation for the patients with esophageal cancer concomitant with liver dysfunction.
abstract: OBJECTIVE
  The aim of this study was to clarify the usefulness of two-stage operation for the patients with esophageal cancer who have liver dysfunction.
  
  
  METHODS
  Eight patients with esophageal cancer concomitant with liver dysfunction who underwent two-stage operation were analyzed. The patients initially underwent an esophagectomy, a cervical esophagostomy and a tube jejunostomy, and reconstruction with gastric tube was performed after the recovery of patients' condition.
  
  
  RESULTS
  The average time of the 1(st) and 2(nd) stage operation was 410.0 min and 438.9 min, respectively. The average amount of blood loss in the 1(st) and 2(nd) stage operation was 433.5 ml and 1556.8 ml, respectively. The average duration between the operations was 29.8 days. The antesternal route was selected for 5 patients (62.5%) and the retrosternal route was for 3 patients (37.5%). In the 1(st) stage operation, no postoperative complications were observed, while, complications developed in 5 (62.5%) patients, including 4 anastomotic leakages, after the 2(nd) stage operation. Pneumonia was not observed through two-stage operation. No in-hospital death was experienced.
  
  
  CONCLUSIONS
  A two-stage operation might prevent the occurrence of critical postoperative complications for the patients with esophageal cancer concomitant with liver dysfunction.
authors.affiliation: Emergency and Critical Care Center, Kyushu University Hospital.
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Yasuda
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Saeki
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Nakashima
authors.forename: Takafumi
authors.initials: T
authors.lastname: Yukaya
authors.forename: Satoshi
authors.initials: S
authors.lastname: Tsutsumi
authors.forename: Hirotada
authors.initials: H
authors.lastname: Tajiri
authors.forename: Yoko
authors.initials: Y
authors.lastname: Zaitsu
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Tsuda
authors.forename: Yuta
authors.initials: Y
authors.lastname: Kasagi
authors.forename: Koji
authors.initials: K
authors.lastname: Ando
authors.forename: Yu
authors.initials: Y
authors.lastname: Imamura
authors.forename: Kippei
authors.initials: K
authors.lastname: Ohgaki
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Akahoshi
authors.forename: Eiji
authors.initials: E
authors.lastname: Oki
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Maehara
mesh_terms: D000368:Aged; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D006801:Humans; D008107:Liver Diseases / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000517:prevention & control