AN ANALYTICAL STUDY OF CARCINOMA OESOPHAGUS AND ITS SURGICAL MANAGEMENT
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 48
Abstract
BACKGROUND Carcinoma oesophagus is the 6th most common cancer in the world. Overall, a 5-year survival rate with treated tumour is 5 to 20% only. But still most patients with carcinoma oesophagus could not be diagnosed earlier because of late presentation. The aim of this study is to know the regional incidence, common histological types, clinical features and investigations to aid diagnosis, to know the common site and to know operability of carcinoma oesophagus. MATERIALS AND METHODS This study was conducted in Mahatma Gandhi Memorial Government Hospital, Trichy between September 2013 and June 2015. This study included 88 patients of carcinoma oesophagus who were managed through Feeding Jejunostomy with Radiotherapy referral, Transhiatal Oesophagectomy, Thoracoscopic Oesophagectomy and were studied for their regional incidence, clinical features and investigations to aid diagnosis, to know the common site and to know operability of carcinoma oesophagus. The study design was descriptive. RESULTS The incidence of carcinoma oesophagus in Mahatma Gandhi Memorial Govt. Hospital, Trichy has been worked out to be 5.2%. Carcinoma oesophagus is commonly seen in 7th decade of life; 26% of cases falls in the age group of 61 to 70 years. Youngest patients were of 30 years of age and eldest 90 years. The Male-to-Female ratio is 1.4:1. Carcinoma oesophagus patients with alcohol intake is 27%. Most common complaint according to our study is Dysphagia (98%) followed by weight loss (62%). Mostly tumour affects the middle 1/3rd of oesophagus (48%) followed by lower 1/3rd with oesophagogastric junction (31%). Common histological pattern is squamous cell carcinoma (80%) in our study; 51% of patients has ulcerative growth, 43% have infiltrative growth. Out of 88 patients with carcinoma oesophagus, 54% of cases underwent Feeding Jejunostomy and referred to Radiotherapy; 46% of cases have curative surgery done like Transhiatal oesophagectomy (42%), Thoracoscopic Oesophagectomy (3%), Total Gastrectomy with oesophagectomy in 1.1%. Among the patients who underwent curative surgery, 39% have postoperative complications. Anastomotic leak is the highest post-operative complication with 14% incidence. Death in post-operative patients was 2%. During the followup period, 12% of patients were lost. Most of the followup occurred between 7 and 12 months of post-operative period (36%). Patients with recurrence referred to Radiotherapy. CONCLUSION Carcinoma oesophagus have increased the Male-to-Female ratio. It is most common in low socioeconomic group. Predominant histology is squamous cell carcinoma. Strong association exists between smoking, alcoholism and carcinoma oesophagus. Transhiatal oesophagectomy and thoracoscopic oesophagectomy have significant role in surgical management of carcinoma oesophagus of middle and lower 1/3rd. About 50% of patients were inoperable and feeding jejunostomy was done and referred to Radiotherapy.
Authors and Affiliations
Yeganathan Rajappan, Ilavarasi Thangavel, Mahalakshmi Ashokkumar, Manimaran Thangavelu, Anandan Kanthan
Keywords
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- EP ID EP219059
- DOI 10.14260/Jemds/2017/803
- Views 119
- Downloads 0
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