[Results of limited resection of carcinoma of the gastroesophageal junction].

INTRODUCTION

The authors present results of surgical therapy in adenocarcinoma of gastroesophageal junction.

MATERIAL AND

METHODS

The patient set included 14 patients, 7 men and 7 women. The average age of the patients was 72 years. The study only included patients in initial phases of malignant disease, according to EUS category T1, 2, N0. PET/CT ruled out generalization in all patients. Another criterion for this type of resection was general polymorbidity and older patient age. Resection of gastroesophageal junction and lymphadenectomy were performed in all patients. Splenectomy was performed in six patients. Reconstruction of the upper part of the GIT was performed by esophagogastroanastomosis; pyloromyotomy was standard procedure. In two cases resection of the distal esophagus was performed from a right thoracotomy.

RESULTS

No serious complications were observed during the operation. In one patient a cholecystectomy was performed for empyema of the gallbladder together with the resection of the GE junction during which injury of common bile duct occurred. A hepaticojejunostomy was performed. Fistula in anastomosis after the operation was described in four patients, conservative therapy was successful in two cases, in one case surgical treatment was necessary. One woman patient died after fistula complications with development of septic shock and pulmonary failure.

CONCLUSION

Resection of the gastroesophageal junction is surgical therapy for patients in initial stages of adenonocarcinoma of the GE junction if the required criteria of RO resection are fullfilled.