Qutbe Alam Jan, Roohul Muqim, Wagma Nisar, Attaur Rehman Khalil.
Esophagectomies in a general surgical unit.
J Med Sci Jan ;19(1):43-5.

Objective: To report the results of esophagectomies for carcinoma esophagus, in a general surgical unit over a three year period. Material and Methods: Over a three year period, from July 2005 to July 2008, a total of 20 patients with biopsy proven carcinoma of the esophagus considered fit for curative resection underwent esophagectomies in a single Surgical Unit of Khyber Teaching Hospital, Peshawar. The postoperative course was followed closely in hospital for 14 days and out patient follow up was done at 30 days and at six months following surgery. Surgical outcome was assessed in terms of immediate and early postoperative complications, length of ICU stay, and remaining symptom free at 6 month follow up. Results: Of 20 patients, 8 (40%) were referred from other units, while 12 (60%) were admitted through the surgical out patient department. There was a male preponderance of 2.3:1. The age range was from 40 to 75 years. The two-stage Ivor Lewis procedure was performed in 16 (80%) patients and three-stage McKeown procedure in 4 (20%) patients. The average length of Intensive Care Unit (ICU) stay was 56 hours. There was one in-hospital death post operatively due to presumed pulmonary embolism. One patient required thoracotomy for drainage of intra thoracic leak. Thus, 30-day mortality and morbidity were both 5%. At six months, 80% of patients were traced at follow up, and remained symptom-free. Conclusions: We conclude that with the relatively low 30 day mortality and morbidity related to surgery in the observed patients, immediate and early postoperative outcome remain tolerably well.

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