Delayed esophageal replacement by colon interposition in esophageal and gastroesophageal cancer treatment
Purpose-assess the effectiveness of the developed complex antiischemics activities when performing delayed ezofagokoloplastiki in patients suffering from cancer of the esophagus or gastroesophageal cancer. Material and methods. In the N.N. Alexandrov NCCB Department of Thoracic oncopathology delayed colon interposition was performed in 41 patients on for esophageal or gastroesophageal carcinomas from 2007 to 2013 after planned or forced divisive surgery for complications of primary plastics. From this cohort two groups were formed: control (n=21) and the main (n=20) ones. There were patients with classical methods of delayed colon interposition in the control group and the study group with new methods of delayed colon interposition by using of developed ischemic complications prophylaxis complex. Results. In analyzing the structure of post-operative surgical complications it was found that the use of ischemic complications prophylaxis complex allowed to reduce significantly the frequency of postoperative complications to 3.8 times from 57.1 to 15% (p=0.006). Thus the frequency of ischemic complications decreased to 6.6 times from 33.3 to 5% (p=0.024). The developed complex decreases proportional to the risk of specific ischemic complications (graft necrosis, anastomotic leakage) to 9.5 times significantly (p=0.045) according to a logistic regression model. Conclusion. The use of ischemic complications prophylaxis complex during delayed colon interposition improves immediate results in patients suffering from cancer of the esophagus or gastroesophageal cancer, after a planned or forced uncoupling operations.