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Revista do Colégio Brasileiro de Cirurgiões

Print version ISSN 0100-6991On-line version ISSN 1809-4546

Abstract

ALTMANN, Dino Antonio Oswaldo; FERREIRA, Fábio de Oliveira; PAULA, Roberto Anania de  and  FERREIRA, Eugênio Américo Bueno. Transhiatal esofagectomy for adenocarcinoma of the esophagus. Rev. Col. Bras. Cir. [online]. 1999, vol.26, n.5, pp.295-298. ISSN 1809-4546.  https://doi.org/10.1590/S0100-69911999000500008.

Esophagitis associated with Barretts esophagus is a recognized predisponent factor for the development of adenocarcinoma. its incidence has been raising through the last years. Between 1976 and 1993, eleven patients with primary adenocarcinoma of the esophagus were treated. In two cases, the neoplasia occurred in an aberrant gastric mucosa in the cervical and thoracic esophagus. in the remaining cases, the tumor occurred in the distal third of the organ. in columnar-lined (Barretts) esophagus, in patients with hiatal hernia and gastroesophageal refluxo Nine patients were submitted to transhiatal esophagectomy. one to distal esophagectomy with interposition of jejunum. and one to retrosternal esophagogastroplasty without esophagectomy. All but three patients had curative operations. Five patients had early stage disease, without limphonode involvement. There was no operative mortality and the main complications were anastomotic leackage and openning of pleural cavity, both of them occurring, in two patients. The average survival of these patients was 40.5 months. Three patients remain alive and with no evidence of recurrence (Stage 0, I and IIA), with a follow-up of 64, 94 and 117 months. Patients with gastroesophagic reflux and Barretts esophagus must be properly treated and they need endoscopic surveillance for the evaluation of progressive dysplasia or adenocarcinoma. The authors conclude that esophagectomy is a safe procedure and long term survival is possible when these esophageal tumors are treated in the early stages.

Keywords : Cancer of the esophagus; Tumor of the esophagus; Neoplasia of the esophagus; Adenocarcinoma of the esophagus; Barretts esophagus.

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