Özofagus kanseri cerrahisinde komplikasyonlar ve tedavisi

Özofagus kanserinin cerrahi tedavisi ile ilişkili morbidite oranı hasta seçimi, cerrahi teknik ve perioperatif yaklaşımdaki iyileşme ve gelişmeler nedeniyle son yıllarda belirgin derecede düşmüş olmasına rağmen hala yüksektir. Solunum yetmezliği, sepsis, anastomoz kaçağı, özofageal striktür, fistül, reflü, obstrüksiyon, kanama, şilotoraks, pnömotoraks, pankreatit ve dalak yaralanması özofagus kanseri cerrahisinde karşılaşılan başlıca komplikasyonlardır. Solunum fizyoterapisi ve ağrı kontrolü pulmoner komplikasyonların önlenmesinde anahtar iki yaklaşımdır. Anastomoz kaçağı yüksek morbidite ve mortalite oranı ile önemli bir komplikasyondur. Özofageal striktür postoperatif ilk 3 ayda 30-50% olguda görülür. Çoğunlukla tekrar eden dilatasyonlarla tedavi edilir. Hava yolları ve özofagus arasında fistül gelişimi tedavi edilmez ise mortalitenin kaçınılmaz olduğu bir komplikasyondur. Yüksek morbidite ve mortalite oranlarına rağmen özofagus kanserinde cerrahi tedavi esas tedavi yöntemidir.

Anahtar Kelimeler:

Özofagus kanseri, Rezeksiyon, Özofajektomi, Anastomoz, Komplikasyon, Morbidite

Complications of esophageal cancer surgery and treatment

Morbidity rate associated with surgical treatment of esophageal cancer is still high, although it is significantly decreased in recent years according to improvements and developments in patient selection, surgical technique and perioperative approach. Respiratory failure, sepsis, anastomotic leakage, esophageal stricture, fistula, reflux, obstruction, bleeding, chylothorax, pneumothorax, pancreatitis and splenic injuries are major complications of esophageal cancer surgery. Respiratory physiotherapy and pain control are two key approaches in prevention of pulmonary complications. Anastomotic leakage is a significant complication with high morbidity and mortality rate. Esophageal stricture occurs in 30-50% of cases in the first three months, postoperatively. It is often treated with repeated dilatations. Mortality is inevitable for the development of fistula between airways and the trachea, if it is left untreated. Despite its high morbidity and mortality rates, surgical treatment is the main treatment modality of esophageal cancer.

Keywords:

Esophageal cancer, Resection, Esophagectomy, Anastomosis, Complication, Morbidity,

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Journal of Experimental and Clinical Medicine-Cover

Yayın Aralığı: Yılda 4 Sayı
Başlangıç: 1980
Yayıncı: Ondokuz mayıs Üniversitesi Tıp Fakültesi

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