Background: Lewis surgery has been applied in the Department of Digestive Surgery, Viet-Duc hospital since 1991 and became routine surgery in the treatment of the lower two-thirds of the esophagus cancer. Objective: To present Lewis technique and results of operation in treating the lower two-thirds of the esophagus cancer. Subjects and methods: The study was carried out on 90 patients (86 men and 4 women) with the lower two-thirds of the esophagus cancer operated by the Lewis\u2019s technique. The average age of these patients was 52.3 \xb1 9.2. \r\n', u'Results: Disease stages: stage I: 2 cases (2.2%), stage IIA: 23 cases (25.6%), stage IIA: 23 cases (25.6%), stage IIB: 10 cases (11.1%), stage III: 42 cases (46.7%), stage IV: 13 cases (14.4%). There were three cases of postoperative death (5.6%). 34 cases had surgical complications or complications after surgery. The average survival time of patients after surgery was 23.8 months \xb1 2.8. Postoperative survival time of 1 year, 2 years, 3 years, 5 years was 58.2%, 39.2%, 23.4% and 12.0% respectively.\r\n', u'Conclusion: Mortality and postoperative complications of the surgery were low. So it should be selected for the treatment of the lower two-thirds of the esophagus cancer. The surgery helped 96.5% of patients to eat normally again. 5-year survival time after surgery was low because of diagnosis and surgery in late stages\r\n', u'\r\n', u'
Esophageal Neoplasms/ surgery

Background: Surgical treatment of esophageal carcinoma is a main operation in term of both technique and anesthesiology. The Orringer technique is one of the treatments. Objectives: 1. To describe clinical and subclinical characteristics of the middle and lower-third esophageal carcinoma. 2. To assess preliminary results of Orringer technique in treating of the middle and lower-third esophageal carcinoma. Subjects and method: A prospective, descriptive, following by time study was conducted in the patients who were diagnosed the middle and lower third esophageal carcinoma and operated by Orringer technique at the Department of Digestive Surgery in Viet Duc Hospital from January/2000 to June/2006. Results: The subclinical symptoms included difficult swallow (98.5%), anorexia and loss weight (98.5%), pain in chest (23.5%), loss of voice (2.9%) and bloody vomiting (5.9%). For clinical symptoms, 54/68 patients (79.4%) had lesions in lower-third esophageal, 14/68 (20.6%) had lesions in the middle-third esophageal. The average length of the lesions was 6.23\xb12.22cm (95% CI=5.69-6.77). The average operation time was 273.38 \xb154.56 minutes (range: 140-420), which is much faster than those in esophagectomy via thoracotomy: Lewis-Santy technique (324 minutes) and Akiyama technique (480 minutes). Both intraoperative and post-operative complications of Orringer technique were less than those of esophagectomy via thoracotomy. Conclusion: In this study, the clinical and subclinical strongest characteristics of the patients with the middle-third esophageal carcinoma appear in the advanced period (III period and IV period (over 70%)). Orringer technique had faster operation time, less complications and lower mortality than those of esophagectomy via thoracotomy.
Esophageal Neoplasms/ surgery ; therapy

Review of 84 patients with esophagus cancer operated from 1994 to 2000 by different techniques of esophagectomy was presented. 77 patients alived after operation were followed up to for survival and 12 prognosis factors were referred to this study. Survival time was calculated as 57.3%, 2 years survival 34.3%, 3 years survival 24.2%, and 5 years survival was 10.2%. By single analysis method, 5 factors having affected significantly to survival time were palliative or curative operation, the degree of differentiation of the tumour, ganglion metastasis and the TNM staging (p<0.05).
Surgery ; Esophageal Neoplasms

Background: Esophageal cancer is a common disease at Digestive Surgery Department of Binh Dan hospital. Surgical treatment is still a main procedure. Objectives: Study on a less invasive surgical technique in esophagectomy with supported thoracoscopy to provide a new esophageal cancer treatment. Subjects and method: Application on a new technique via thoracoscopy to esophagectomy totally in 6 patients (1 female, 5 males), aged 60 years on average, treated in Digestive Surgery Department of Binh Dan hospital from March 2006 to June 2006. Results: The average surgical time was 260 minutes. There was no event during operation. Postoperative complications included: 1 patient had to stitch abdominal wall after operative 7 days, 3 patients with pneumonia after successful operation, 2 patients with right pneumothorax, having to put siphonage. There was one case of death without related to operative technique. Conclusion: Esophagectomy is major operation that can be conducted via open surgery or laparoscopic surgery. Although small case studies, researchers found that laparoscopic surgery is a feasible technique, can be performed safely if the surgeons having experience in open surgery and good skills on laparoscopic surgery. However, thoracoscopic esophagectomy can only be considered as a surgical method, without an alternative method to traditional open surgery.
Esophagectomy ; Esophageal Neoplasms/surgery ; Thoracoscopy ;

Background: Esophageal cancer is a disease with poor prognosis and the treatment is very difficult, requiring a combination of methods (surgery, radiotherapy and chemotherapy), in which surgery remains the most important method. However, quality of life of patients was still less interested in the studies. Objectives: to evaluate the quality of life of patients after esophageal cancer surgery in the Department of Digestive Surgery \ufffd?Viet Duc Hospital from 1994 to 2004. Subjectives and Method: a prospective study was conducted on 164 patients with esophageal cancer surgery at Viet Duc Hospital from January 1994 to June 2004. Results: mortality of the surgery was 5%, and rate of complications was 32.9%. 146 patients were closely followed up the quality of life after the surgery, showed: postoperative quality of life was good and moderate (80.1%). Quality of life of patients with radical surgery were better than that in patients without radical surgery, there was statistically significant with p <0.05. Mean postoperative survival time was 24.2 \xb1 2.3 months. Conclussions: surgery of esophageal cancer improved quality of life of patients. Radical features of surgery significantly influenced the quality of life of patients after surgery.
Esophageal Neoplasms/ surgery ; Quality of Life ;

Humans ; Pharyngeal Neoplasms ; Esophageal Neoplasms/surgery*

Stomach is the first choice for esophageal reconstruction following esophagectomy. In the earlier days, however, whole stomach pulling-up was the major surgery, which had some shortcomings. Recently, gastric tube has gained wide acceptance for esophageal reconstruction. This paper summarized the anatomical and physiological advantage of stomach, the disadvantage of whole stomach, and benefits of gastric tube for esophageal reconstruction.
Esophageal Neoplasms ; surgery ; Esophagectomy ; Humans ; Reconstructive Surgical Procedures ; Stomach ; surgery

The efficacy of surgery alone for locally advanced esophageal squamous cell carcinoma (ESCC) is limited. In-depth studies concerning combined therapy for ESCC have been carried out worldwide, especially the neoadjuvant treatment model, including neoadjuvant chemotherapy (nCT), neoadjuvant chemoradiotherapy (nCRT), neoadjuvant chemotherapy combined with immunotherapy (nICT), neoadjuvant chemoradiotherapy combined with immunotherapy (nICRT), etc. With the advent of the immunity era, nICT and nICRT have attracted much attention from researchers. An attempt was thus made to take an overview of the evidence-based research advance regarding the neoadjuvant therapy of ESCC.
Humans ; Esophageal Squamous Cell Carcinoma/surgery* ; Neoadjuvant Therapy ; Esophageal Neoplasms/surgery* ; Chemoradiotherapy ; Esophagectomy

There are several controversies and issues in the surgical treatment of esophagogastric junction (AEG) currently. The Siewert classification and TNM staging system are commonly used to assist clinical decision and prognosis prediction. Generally, transthoracic procedure is more suitable for Siewert Ⅰ type and longer esophageal invasion patients, while transhiatal is more suitable for Siewert Ⅲ type patients. The optimal extent of lymph node dissection for AEG should be based on tumor location and esophageal invasion range. The extent of surgical resection and the method of digestive tract reconstruction should be based on the principle of radical resection and surgical safety, and the postoperative life quality of patients should be fully considered. Roux-en-Y anastomosis is the most common and efficient anastomosis after total gastrectomy, while double tract anastomosis is recommended by many experts after proximal gastrectomy. With the continuous advancement of minimally invasive techniques, experienced centers and teams can perform digestive tract reconstruction under total laparoscopy. In the future, more high-quality studies are expected to provide evidence-based medical evidence for AEG's surgical treatment decisions.
Adenocarcinoma/surgery* ; Esophageal Neoplasms/surgery* ; Esophagogastric Junction/surgery* ; Gastrectomy/methods* ; Humans ; Stomach Neoplasms/surgery*

In recent years, adenocarcinoma of esophagogastric junction (AEG) has received increased attention from the academic community. However, the esophagogastric junction (EGJ) straddles two anatomical regions: the thoracic cavity and the abdominal cavity. The histological features of the EGJ are different from those of the esophagus and stomach. There are general disagreements among the related disciplines regarding the definition and classification of AEG. By summarizing the views of different disciplines, including endoscopy, radiography, and pathology, a more comprehensive definition of the EGJ was formulated in the Japanese Classification of Gastric Carcinoma (the 15th edition), and the principle of endoscopic diagnostic priority was established. In recent years, with the development of physiological and anatomical studies, the EGJ has gradually expanded conceptually into a complex functional anatomical region covering the distal esophagus to the proximal stomach. The venous and lymphatic vessels in the EGJ are characterized by bidirectional flow, which is an important anatomical basis for the invasion and metastasis patterns of tumors in this region. The clinical practice of EGJ cancer has been promoted by the creation of Nishi and Siewert classification systems. With the support of a series of clinical studies for its scientificity and effectiveness, the Siewert classification is widely accepted by the international community, and successively introduced into major international practice guidelines. In general, the staging and management of Siewert Ⅰ and Ⅱ AEG are recommended as esophageal cancer, while Siewert Ⅲ AEG is recommended for gastric cancer. However, in the Japanese guidelines for the treatment of esophageal and gastric cancers, the Nishi classification is still used to define and classify EGJ cancer. Recent year, a Chinese consensus on the surgical treatment of AEG was formulated by multidisciplinary experts. The main controversies were summarized in the consensus, and proposals that incorporate the domestic situation were also presented. At present, only by returning to the basic anatomical and physiological perspectives, strengthening multidisciplinary communication and cooperation, and with the help of emerging bioinformatics, digital, and material technology, can it be possible to get out of the dilemma faced by traditional AEG classification and staging system.
Adenocarcinoma/surgery* ; Esophageal Neoplasms/surgery* ; Esophagogastric Junction/surgery* ; Humans ; Stomach Neoplasms/surgery*