초록접수 현황
| 16F-121 | 구연 발표 |
Surgical Outcome of Colon Interposition in Esophageal Cancer Surgery.
Seung-Il Park, Dong Kwan Kim, Yong-Hee Kim, Se Hoon Choi, Kanghoon Lee, Su Kyung Hwang, Jin San Bok, Han Pil Lee, Byung Kwon Chong, Hyeong Ryul Kim
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea
Background : The aims of this study are to review the feasibility and surgical outcomes of colon interposition in patients with esophageal cancer.
Methods : We retrospectively reviewed the data of patients with esophageal cancer who underwent colon interposition for esophageal reconstruction between June 2000 and June 2013.
Results : Total 67 consecutive patients were included and mean age was 62.2 ±7.9 years. The reasons for choosing colon conduits included previous gastrectomy for peptic ulcer in 9(13.4%), metachronous gastric cancer in 19(28.4%), synchronous gastric cancer in 26(38.8%), and gastroesophageal junction cancer in 13(19.4%). Twelve patients(17.9%) underwent neoadjuvant chemoradiotherapy(CRT). The median operative time was 425.0 minutes(range; 230-640. Median follow-up duration was 44 months(range; 1~168). Median survival time was 63 months(range; 1-168, 95% CI 36.8-89.2). 3-year and 5-year overall survival rates were 61.6% and 49.4%. Total 43 patients(64.2%) experienced at least one postoperative morbidity. Assessed by Clavien-Dindo grading system, 36 patients(54%) suffered from postoperative morbidity more than Grade III. Pulmonary complication was most common(18 patients, 26.9%) and 10 patients(14.9%) treated for aspiration pneumonia(more than Grade II). Anastomosis site leakage occurred in 11(16.4%), and three of them(6.0%) went to graft failure. 9 patients(13.4%) underwent endoscopic ballooning for anastomosis site stricture. In multivariate analysis, neoadjuvant CRT(p=0.013, HR=6.37, 95% CI 1.47-27.58) was significant risk factor for conduit-related complication (leakage, graft failure and stricture more than Grade III).
Conclusion : Colon interposition is associated with relatively high complication rate. Neoadjuvant CRT was related with conduit morbidity.
Methods : We retrospectively reviewed the data of patients with esophageal cancer who underwent colon interposition for esophageal reconstruction between June 2000 and June 2013.
Results : Total 67 consecutive patients were included and mean age was 62.2 ±7.9 years. The reasons for choosing colon conduits included previous gastrectomy for peptic ulcer in 9(13.4%), metachronous gastric cancer in 19(28.4%), synchronous gastric cancer in 26(38.8%), and gastroesophageal junction cancer in 13(19.4%). Twelve patients(17.9%) underwent neoadjuvant chemoradiotherapy(CRT). The median operative time was 425.0 minutes(range; 230-640. Median follow-up duration was 44 months(range; 1~168). Median survival time was 63 months(range; 1-168, 95% CI 36.8-89.2). 3-year and 5-year overall survival rates were 61.6% and 49.4%. Total 43 patients(64.2%) experienced at least one postoperative morbidity. Assessed by Clavien-Dindo grading system, 36 patients(54%) suffered from postoperative morbidity more than Grade III. Pulmonary complication was most common(18 patients, 26.9%) and 10 patients(14.9%) treated for aspiration pneumonia(more than Grade II). Anastomosis site leakage occurred in 11(16.4%), and three of them(6.0%) went to graft failure. 9 patients(13.4%) underwent endoscopic ballooning for anastomosis site stricture. In multivariate analysis, neoadjuvant CRT(p=0.013, HR=6.37, 95% CI 1.47-27.58) was significant risk factor for conduit-related complication (leakage, graft failure and stricture more than Grade III).
Conclusion : Colon interposition is associated with relatively high complication rate. Neoadjuvant CRT was related with conduit morbidity.
첨부파일 : Table.docx
책임저자: Hyeong Ryul Kim
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea
발표자: Kanghoon Lee, E-mail : kumcjklee@gmail.com