Ene D., Turculet C., Haiducu Carmen
Department of Surgery, Clinical Hospital Emergency, Bucharest
Abstract
The surgical approach of eso-gastric tumours is extremely difficult because of the regional anatomical and functional particularities, thus deciding the correct surgical attitude is essential. Objective. The purpose of this study is to compare the surgical outcome of patients with abdominal approach of eso-gastric tumours versus the abdomino-thoracic one. Although tackling the oesophageal-gastric junction is difficult on its own, the main goals are a Ro resection and as little invasive operations as possible. Materials and method. Our study is an observational, retrospective study of immediate postoperative outcome in terms of morbidity and mortality. During 2000-2010, we assessed 79 patients, from the Clinical Emergency Hospital in Bucharest and the Clinical Hospital in Craiova, in terms of early postoperative outcome after eso-gastric cancer resection. We decided to enrol patients from two medical centres because of a low incidence of eso-gastric tumours in our country. Conclusions. The abdominothoracic approach should be avoided due to its major complications. The abdominal approach may be implemented in type I tumours as well, in addition to types II and III. The abdomino-thoracic approach allows a correct oesophageal resection above the tumour, as well as a thorough mediastinal lymph node dissection and it is mainly indicated in type Siewert I tumours. The operative mortality was 0% for both surgical approaches. The postoperative mortality rate was 15.18%.