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ESOPHAGECTOMY IN A SOUTH AMERICAN CANCER CARE CENTER
Bernardo Borraez*1,2, Jaime A. Montoya3, Ricardo Oliveros1, Raul Pinilla1, Paula A. Meneses4, Diego Cardona4, Mario Abadia1
1Gastrointestinal Surgery and Endoscopy, Instituto Nacional de Cancerologia / Universidad Militar Nueva Granada, Bogota, Colombia; 2General Surgery , Shaio Clinic Foundation, Bogota, Colombia; 3Gastrointestinal Surgery and Endoscopy, Instituto Nacional de Cancerologia / Universidad Militar Nueva Granada, Bogota, Colombia; 4Instituto Nacional de Cancerologia, Bogota, Colombia
Background. South America is a geographical area of intermediate incidence of esophageal cancer, with a progressive increase of the disease and uncommonly early diagnosis. Even though the surgical resection is the keystone treatment, survival rate is still poor, with a high rate of complication.
The aims of this study were to: a) Show our experience at a South American cancer care center in Bogotá, Colombia and b) Compare postoperative complications and presence of anastomotic leaks between the different anastomosis techniques.
Methods. Retrospective review of a prospective database. Thirty patients who underwent esophagectomy for esophageal cancer in a single tertiary cancer care center between 2012 and 2016. Twenty two open and 8 laparoscopic approach. We compared the postoperative complications rate and anastomotic leaks rate between: a) side to side vs. end to side anastomosis, b) cervical vs. intra-thoracic anastomosis, c) stapler vs. hand sewn anastomosis and d) Circular vs. linear stapler.
Results. Postoperative complications were present in 56,7 % of patients. Anastomotic leak was present in 30 % of patients. Mortality rate was 6,7 %. Anastomotic leaks were more frequent in older patients and female gender (p = 0.0116 and 0.0301 respectively). No statistical differences were present between: a) side to side vs. end to side anastomosis, b) cervical vs. intra-thoracic anastomosis, c) stapler vs. hand sewn anastomosis and d) circular vs. linear stapler.
Conclusions The results of this study of patients in whom esophagectomy was performed in a South-American cancer care center showed that: a) Even though South America is an area of intermediate incidence of esophageal cancer, it is still an infrequent disease and b) Our findings suggest that in older patients and female gender anastomotic leaks may be more common. Studies with a larger number of patients will determine the validity of these results.
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