MEDIASTINAL AND ABDOMINAL NODE DISSECTION FOR CARCINOMA OF THORACIC AND ABDOMINAL ESOPHAGUS

Document Type : Original Article

Authors

1 Department of surgery, National Cancer Institute, Cairo University, Egypt

2 Department of pathology, National Cancer Institute, Cairo University, Egypt

3 Department of Anesthesia and Pain Relief, National Cancer Institute, Cairo University, Egypt

Abstract

Aim: To evaluate the safety and complications of mediastinal and abdominal dissection in association with subtotal and 
total esophagectomy for carcinoma of thoracic and abdominal esophagus. 
Methods: 29 patients having curable carcinoma of the esophagus underwent mediastinal and abdominal node dissection. 
Subtotal esophagectomy was performed in 16 patients while total esophagectomy was performed in 13 patients.
Results: Pathological staging was: stage I 0%, stage IIA 24%, stage IIB 62% and stage III 13%. Positive mediastinal and 
celiac lymph nodes was found in 38% with a mean number of 6 (range1 -12). The mean number of dissected lymph nodes was 14 (range 8 - 34). Chest infection occurred in 27%. Early surgical complications were intrathoracic anastomotic leakage 6%, cervical leakage 10%, anastomotic bleeding in one patient and recurrent laryngeal nerve palsy in two patients. Postoperative mortality was 10%. Four patients had locoregional recurrence. Three-year survival rate were 21 % for stage IIA and ranged from 11- 0% for stage IIB and III. 
Conclusion: The technique of mediastinal and abdominal dissection can be performed with subtotal and total esophagectomy with low rate of complications. This leads to more accurate staging, but it is unclear from this small study whether it has an impact on the survival or not.

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