Laparoscopic esophagus surgery through diaphragm treatment for esophagus cancer

The esophagus is a part of the human digestive tract, and cancer comes from the esophagus. Esophagus cancer is a malignant disease caused by uncontrollably divided esophagus cells, including two main types of cancer, sscaly and glandular melanoma.

• Sscaly epithalous cancer originates in epidermis cells in the wall of the esophagus, and the common location is in the upper and middle parts of the esophagus.
• Glandular meacular cancer originates from cells in the glandular organization of the esophagus, which is common in the lower esophagus position.

Ovarian cancer can invade the outside of the esophagus, meta metalysing according to the lymphatic system and to other bodies, such as the liver, spectrum, bones, brain,… In Vietnam, esophagus cancer is one of the five most common gastrointestinal cancers.

In the treatment of esophagus cancer, surgery is a basic and predominant treatment, chemotherapy and radiotherapy are complementary treatments.

Thoracic and abdominal laparoscopic surgery has the advantage of good lymph node dredging, but cannot be carried out for cases with thickening of the pleura, or cases where tumors exist at 1⁄3 below but are not able to assess the problem spreading to the bulge center, so , laparoscopic encescopy surgery through the diaphragm was born to overcome the situations mentioned above.

2.1

Introscopy surgery in which the diaphragm is performed:

• Patients with lower 1⁄3 esophagus cancer, stage T1 – T3, regardless of metasy (N0 or N1)
• Patients with typ I and typ II psychobular cancer as classified by Siewert in 1987.

2.2 Contrainning

Contraintent of laparoscopic encescopy surgery via diaphragm:

• Patients with cervical and thoracic esophagus cancer at 1⁄3 upper or 1⁄3 middle.
• Patients with esophagus cancer are located at 1⁄3 below but the tumor is large in size.
• Patients with many serious coordinated general body diseases, such as respiratory failure, heart failure, kidney failure,…

• There is a history of surgical peritonitis, intestinal obstruction, obstruction neck, umbilical hernia, abdominal wall hernia, local infection of the abdominal wall, diseases of coa clotting disorders,…
• Patients with contrainments to peritoneal inflatables: Coronary artery pathology, diseases of the heart valves, chronic heart.
• The patient does not agree to perform treatment by laparoscopic encescopy through the diaphragm slit.

The patient should be completed the following issues before undergoing laparoscopic encephalectect opening surgery through the diaphragm:

• Explained by the doctor, advising on the current condition as well as the method of laparoscopic esophagus removal surgery through the diaphragm to treat cancer.
• Complete basic tests, endoscopy, ultrasound, X-rays, chest-abdominal computer cts and other necessary tests and techniques.
• The patient's condition is nurtured to ensure that the surgery is met, the results of pre-anaesthesia examination are favorable.
• Use of pre-surgery pre-surgery antibiotics.

After performing laparoscopic estoscopy through the diaphragm, the steps of care and monitoring of patients include:

• Monitor for signs of patient survival.
• Monitor pleural circulation and other conduction placed in surgery.
• Use antibiotics after surgery.
• Water and electrolys additives.
• Nutrition restores fitness.

Like other types of surgery, the process of performing laparoscopic otoscopy surgery through the diaphragm also has certain risks and complications, such as:

• Perforation of the esophagus.
• Torn bronchi.
• Large blood vessels are damaged.
• Bleeding after surgery.
• Respiratory failure.
• Fistula, oral probing.

If there are such complications, it is best to immediately notify the treating doctor, and select nearby and reputable medical facilities for timely emergency and treatment.

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