European Journal of Molecular & Clinical Medicine

Carcinoma oesophagus infiltrates locally involving adjacent lymph nodes and metastases widely by hematogenous spread. Esophageal cancers typically spread both by direct invasion and also via network of lymphatics. Hematogenous spread is more common in patients with advanced stages of diseases. Lungs and the liver have been regarded as the usual sites of hematogenous metastases. Out of all these patients, 78 patients were selected on the basis of histopathological examination (HPE) report showing the confirmed presence of carcinoma of the esophagus. After taking a properly informed written consent and complete history, a thorough clinical examination was done and these patients were subjected to CT scan. Clinical and radiological data from the study was recorded as per the proforma. Lymph nodal staging was done as per TNM staging in which N2 stage was seen maximum in 33 patients (42.3%) followed by N0 stage in 22 (28.2%) patients. 13 patients out of 78 were staged under N1 category (16.7%) and only 10 patients out of 78 (12.8%) showed N3 stage of lymph nodal spread. In our study out of 78 patients, 14 patients showed evidence of distant metastases (17.9%)-M1 stage. Rest 64 patients (81.1%)-M0 stage.

Background: Anastomotic leak from cervical esophagogastric anastomoses is a serious problem after esophagectomy. Various modifications of anastomotic techniques have evolved to minimize anastomotic complications. This study presents the technique of cervical esophagogastric anastomosis using linear cutting staplers and experience with the technique compared to the hand-sewn anastomosis. Materials and Methods: 200 patients with oesophagus or gastroesophageal junction carcinoma underwent curative-intent resection either via a right posterolateral thoracotomy (TTE) or transhiatal esophagectomy or video-assisted thoracoscopic surgery. 160 patients with treated with linear stapler technique (Group A) and 40 patients were treated with hand-sewn anastomosis. (Group B) The average follow-up was approximately 18 months. Results: Anastomotic leakage was observed in three patients (1.75%) in linear anastomosis technique and eleven patients (27.7%) in hand-sewn technique. There was no incidence of anastomotic site stricture in group A. In contrast, three patients (6.25%) had post anastomotic stricture in group B. Early postoperative morbidity in the form of respiratory infections was seen in 15 patients in linear stapler group as compared to 8 patients in the hand-sewn group.