Acta Médica Costarricense
Print version ISSN 0001-6012
MAINIERI-HIDALGO, José Alberto. Reseción esofágica por cáncer, experiencia del Servicio de Cirugía de Tórax del Hospital Dr. Rafael Á. Calderón Guardia. Acta méd. costarric [online]. 2007, vol.49, n.4, pp. 210-215. ISSN 0001-6012.
Between 1990 and 2006, 28 patients had esophageal cancer resection at the Department of Thoracic Surgery of the Hospital Calderón Guardia of the Costa Rican Social Security System. The mean age was 65 years with a high male predominance of 6:1. Eighty percent of the patients were smokers, 75% drinkers and 8 patients had previous diagnosis of Barrets esophagus. Dysphagia, epigastric pain and weight loss were the most frequent symptoms but the pain was related to preexisting peptic disease or esophagitis secondary to gastric reflux. Stage IIb, III and IV patients received neoadyuvant therapy. Three of these cases did not show residual tumor and 2 had residual aortic disease. Twenty one patients had total esophagectomy and 7 patiens had partial esophagectomies with gastric anastomosis in 5 and 2 esophagojejunostomies. Major complications were respiratory distress and bronchopneumonia in 7 patients, and anastomotic leak in 2. Thirty days mortality was 10.7%. The 3 patients died with bronconeumonía and one with cervical and other thoracic leak. Seven patients developed anastomotic strictures treated with dilatations. Survival at 5 and 10 years was 31.5% and 18% respectively.
Keywords : esophageal cancer; esophageal surgery; gastric pull-up.