Learning objectives
The aim of our study is to describe the postoperative imaging (chest radiography,
esophagography and Computed Tomography (CT) findings associated with esophagectomy surgical techniques and to demonstrate esophagectomy postoperative complications.
Background
Esophagectomy is performed to treat both malignant (esophageal cancer is currently the eighth most common malignancy in the world) and benign diseases of the esophagus.
The procedure is technically demanding and carries risk for severe complications.
Esophagectomy presently has the highest mortality rate among all elective gastrointestinal surgical interventions,
ranging from 8%–23%.
The Society of Thoracic Surgeons General Thoracic Surgery Database lists 14 different methods for performing esophagectomies.
The surgical approach is usually selected on the basis of the distance of the tumor site from...
Findings and procedure details
We retrospectively reviewed the patient files and postoperative imaging findings of 87 patients (69 male/18 female) submitted to esophagectomy between 2010 until 2017.
The following surgical techniques of esophagectomy were performed: McKeown procedure Fig. 4 ,
(49 patients),
Ivor-Lewis procedure Fig. 5 (18 patients),
left thoracoabdominal approach (4 patients),
transhiatal esophagectomy Fig. 6 (11 patients),
extended gastrectomy with intrathoracic anastomosis (3 patients) and reconstruction of the esophagus by substernal descending colon interposition Fig. 7 and free jejunal transfer Fig. 8 (2 patients).
The post-esophagectomy complications...
Conclusion
The knowledge of esophagectomy surgical procedures and their potential complications is vital in the aftercare of these patients because the diversity of surgical procedures and the resultant postoperative anatomic changes make image interpretation difficult.
Familiarity with the postoperative complications associated with various surgical options and awareness of patterns of tumor recurrence are essential for evaluating the effectiveness of surgery and for early diagnosis and treatment in patients undergoing curative resection for localized resectable esophageal cancer.
Personal information
Maria Sidiropoulou,Consultant Radiologist,
Department of Medical Imaging,
Hippokrateio General Hospital,
Thessaloniki,
Greece.
E-mail:
[email protected]
Konstantinos Ballas,
Associate Professor,Fifth Surgical Clinic,
Medical School,
Aristotle University of Thessaloniki,
Hippokrateio Hospital,
Thessaloniki,Greece.
Georgios Sapouridis,
Radiologist,Department of Medical Imaging,
Hippokrateio General Hospital,
Thessaloniki,
Greece.
Ioannis Gkoutziotis,
Resident,Fifth Surgical Clinic,
Medical School,
Aristotle University of Thessaloniki,
Hippokrateio Hospital,
Thessaloniki,Greece.
Efstathia Stergiopoulou,Radiologist,Department of Medical Imaging,
Hippokrateio General Hospital,
Thessaloniki,
Greece.
Apostolos Kamparoudis,Professor,Fifth Surgical Clinic,
Medical School,
Aristotle University of Thessaloniki,
Hippokrateio Hospital,
Thessaloniki,Greece.
Athanasia Anastasiou,
Director,Department of Medical Imaging,
Hippokrateio General...
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