Author/Editor		Bitenc, Marko; Eržen, Janez; Grosek, Jan; Sok, Mihael
Title		Rak gastroenzofagealnega prehoda - prikaz naših izkušenj
Translated title		Cancer of oesophagogastric junction - our experiences
Type		članek
Source		Gastroenterolog
Vol. and No.		Letnik 9, št. 20
Publication year		2005
Volume		str. 50-2
Language		slo
Abstract		In the article our experience with treatment of patients with cancer of oesophagogastric junction (OGJ) is described. Between 1999 and 2002 we operated 69 patients. There were 13 females and 56 males. Their age was from 43 to 84 years, 64,7 years on the average. We retrospectively sorted the patients according to Siewert classification. There were 9 patients with type 1 tumor. It was not possible to distinct the patients with type II and type III tumor so 60 of these patients were sorted into one group. In patients with type I OGJ cancer we performed subtotal oesophagectomy with mediastinal lymphadenectomy and intrathoracic or cervical oesophagogastrostomy. In patients with type II and type III cancer OGJ we performed total gastrectomy with resection of distal oesophagus and D2 lymphadenectomy. On the average removed 26,4 lymph nodes per operation of which on the average 6,3 were positive after pathological examination. Intrahospital mortality rate was 4,3 %, perioperative morbidity rate 20 %. We strongly suggest that all patients with cancer of 0GJ should be classified according to Siewert classification preoperatively: The planning of the operation should be done individualy for every patient, sometimes even only at laparotomy. We advise subtotal oesophagectomy for type I OGJ cancers and gastroctomy with resection of distal oesophagus for patients with type II and III OGJ cancer.
Summary		V prispevku opisujemo naše izkušnje z obravnavo bolnikov z rakom v predelu gastroezofagealnega prehoda (GEP). V letih od 1999 do 2002 smo operirali 69 bolnikov. 13 je bilo žensk in 56 moških. Stari so bili od 43 do 84 let, v povprečju 64,7 let. Bolnike smo retrospektivno razdelili glede na klasifikacijo po Siewertu. Bolnikov s tipom I je bilo 9, bolnikov tipom II in s tipom III raka GEP nismo uspeli razdeliti v dve skupini, tako jih je bilo v skupno skupino razvrščenih 60. Pri bolnikih z rakom GEP tip I smo opravili subtotalno resekcijo požiralnika ob intratorakalni ali cervikalni ezofagogastrostomiji. Pri bolnikih z rakom GEP tipa II in III pa transabdominalno gastrektomijo z resekcijo distalnega požiralnika. V povprečju smo pri operacijah odstranili 26,4 bezgavke. Od teh je bilo v povprečju histološko pozitivnih 6,3. Zgodnja bolnišnična umrljivost je bila 4,3 %, perioperatvna morbiditeta pa 20%. Pred operacijskim zdravljenjem je bolnike z rakom GEP smiselno razvrstiti po Siewertovi razdelitvi in nato individualno, včasih šele ob laparotomiji, planirati vrsto in obseg operacije. Pri tipu I subtotalno resekcijo požiralnika z mediastinalno limfadenektomijo, pri tipih II in III pa totalno gastroktomijo z resekcijo distalnega požiralnika in D 2 limfadenektomijo.
Descriptors		ESOPHAGOGASTRIC JUNCTION ESOPHAGEAL NEOPLASMS STOMACH NEOPLASMS ESOPHAGECTOMY GASTRECTOMY NEOPLASM STAGING