Esophageal Tumors PDF

Machine Translated by Google Esophageal Tumors Dr. Yusuf Emre Altundal Istanbul Aydin University Faculty of Medicine Department of General Surgery Machi...

Machine Translated by Google Esophageal Tumors Dr. Yusuf Emre Altundal Istanbul Aydin University Faculty of Medicine Department of General Surgery Machine Translated by Google Esophageal cancer The 6th most common cause of death - 5-year survival 18.8% !! Part sav X in a short time > - Machine Translated by Google im zurort/swest pe swallowing odynophagia > normally - · during · Esophages epi allowing squamous > - difficult/discomfort during se Dysphagia Adenocarci aASIA n i · - occurediaret's present was is * Esoprisal Adenocarcinoma-oin lower 1/3 A Esophagy SC2to in Middle 13 --- Sleeve > - We gastrector Narrow Hiatus breth ↑ Nitrate to in order MALIGNANT TUMORS - - Bad nutrition - turtamin Worldwide, although squamous cell carcinoma (SCC) is = more common, adenocarcinoma is more * - common in developed - countries. > in developed countries Esophageal Adenocar > - more my ? ppleat & fat Nitrates , , ((Bad diet)) Intra-abdominat GERD - Barrett's > - Adenoca > - Obesity > - press. 44 - &En in diet Adenoca Espregea - > - - thurnt food - Nitrates · britanning (lBed dret) I * Ys > - m Middle Machine Translated by Google Squamous Cell Carcinoma (60-80%) - - It constitutes 60-80% of esophageal tumors. It is the most - common type. - It is most commonly located in the mid -thoracic esophagus.& Adenocarcinoma (10-30%) is the leading cause of cancer in Western countries. Responsible for more than 50%. Machine Translated by Google Mesenchymal Sarcoma (0.5-1.5%): Mixed tumors 1.5% among all cancers, gastrointestinal cancers It is seen at a rate of 7%. It is more common in rural areas and poor communities. Machine Translated by Google Esophageal cancer & Squamous carcinoma - Cervical id A /Middle //551 Thoracic Adenocarcinoma - Bottom 1/3 Barrett's mucosa Stomach cancer-like It is increasing kobering) Machine Translated by Google Etiology of Squamous Cancer ↑ ↑ widening > - 1 ↑ Inflam. > Barrett - - * Alcohol and cigarette consumption Achalasia Environmental factors? - contaminated Grafes porting mesal Lead/heavy - - Tylosin Food additives Nitrous compounds in burnt meats and - Corrosive esophagitis pickled vegetables - Plummer–Vinson Vitamin deficiency imp. it In alls Epipmetial all shal Riboflavin (B2), vitamin A most -imp for wealth HPV - - resides Mineral deficiencies Diverticulum Zinc and molybdenum M Ke Lokoplaki Machine Translated by Google Adenocarcinoma Sagara-tretica GERD - - - - Barrett's esophagus due to GERD Cigarette it carse Obesity most impo-be Reflux - Metabolic syndrome - Achalasia * If adenocarcinoma develops in patients with achalasia, it is most commonly seen in the middle esophagus. If adenocarcinoma develops in patients with Barrett's esophagus, it is most commonly seen in the lower esophagus. # & even don't see anything in gasses was if we > - we REDO it in 6 months- > To BE 100 % Sure Machine Translated by Google Esophagogastric Junction (EGJ) Adenocarcinomas – Siewert classification EGJ adenocarcinomas, except Siewert 3 tumors, are called esophageal tumors. (Tumors 2-5 cm distal from EGJ) – Siewert 3 · Seiwert ↳Esophagectomy ! saf = Esophagea - -zline · 2 Type 3-Gastries Machine Translated by Google out All Esopharm take F I amelizat Seinert Fast ****Re Machine Translated by Google Esophageal cancer Histological type Squamous cell ca Localization Thoracic region Machine Translated by Google Esophageal cancer Dysphagia (progressive) &ka 5 : 30 The most common symptom -2 circular longitudinal- Late finding due to absence of serosa (60% infiltration) Seei Still Nucosa in circular - Mucosa- submucosa- Muscularis Propria => - 1s layers) Mucosa: Epithelium- Lamina Propria- Muscularis Mucosa Warm foods are better tolerated. First of all, difficulty in swallowing solid foods occurs. occured presentation-rebashasis Pain at Metastasis-direct invasion? &A Aspiration pneumonia Invasion-Tracheoesophageal fistula Weight loss, weakness, Pyrosis First finding in cardiac tumors Systemic organ metastasis jaundice and bone pain Distant metastasis in more than 40% Machine Translated by Google , Esophageal cancer ! Spread Direct invasion Lymphatic *** invasion& ↳ Most frequently Vascular invasion *** Liver (2), lung, bone · why ? be drainage of - Lower esophages is to Live Machine Translated by Google Esophageal cancer Barium esophagus X-ray The first thing to do is 8 Irregular narrowing of the lumen sign - Finger-print Machine Translated by Google Esophageal cancer *** Esophagoscopy: ~ The best diagnosis is biopsy - Definitive Diagnosis Biopsy partilage ince Chromoendoscopy (Iugol and toludine blue) early diagnosis Endomicroscopy Machine Translated by Google Esophageal cancer Esophagoscopy: The best diagnosis is biopsy Chromoendoscopy (Iugol and toludine blue) early diagnosis NBI · Flat = SCL lesionflite Machine Translated by Google Esophageal cancer Machine Translated by Google Esophageal cancer Endoscopic ultrasound T staging lymph node status Machine Translated by Google Esophageal cancer IT Thorax - upper abdomen Locoregional disease staging Machine Translated by Google Esophageal cancer PET Locoregional disease staging Bronchoscopy Bronchial infiltration? Machine Translated by Google Esophageal cancer Treatment Palliative Endoscopic treatments (palliative) Bougie, intubation, stent, electrocoagulation and laser Radiotherapy Curative Endoscopic treatments Neoadjuvant RT Surgery Machine Translated by Google Machine Translated by Google Early Stage Esophageal Cancer sure not Suspicious full-thickness wall involvement of the tumor or less than 8 lymph nodes involved Machine Translated by Google Esophageal cancer Endoscopic treatments Endoscopic Mosal Resection EMR - Less than 2 in diameter Well or moderately differentiated No muscularis mucosa invasion No lymphovascular invasion Lateral and deep borders are clean Desection ESR - Endoguic Gabrncosal Machine Translated by Google Esophageal cancer Machine Translated by Google Esophageal cancer Operability Localization of the tumor is of secondary importance. The possibility of resection is low for tumors larger than 8 cm. Depth of tumor wall penetration N2 or 5 or more lymph node metastases (-) if curative resection should be attempted Presence of metastasis General situation Advanced age (75) Cachexia Pulmonary insufficiency, cardiac, renal, hepatic insufficiency EF below 40 Machine Translated by Google Esophageal cancer Cervical esophageal cancers Radiation and surgery have equal survival Surgery in limited cases Pharyngolaryngoesophagectomy + pharyngogastrostomy Thoracic inlet (Supraaortic region) Resection is difficult (neighborhood) Neoadjuvant chemo-radiotherapy Reducing the size Esophagectomy + esophagogastrostomy Machine Translated by Google Esophageal cancer Lower esophageal and cardia tumors Adenocarcinoma Treatment is combined with surgical lymph node dissection Longitudinal lymph flow Skip metastasis (+) Esophagectomy Solid border 10 cm Continuity Ideal colon Mostly stomach Less jejunum Right gastroepiploic, right gastric artery should be protected Machine Translated by Google Esophageal cancer Complication Anastomotic leakage is the most common (2-30%) Respiratory problems Mortality rates 0.8-37.5% Life expectancy After resection Average 5 years 18% Early diagnosis is 50-75% Chemoradiotherapy Neoadjuvant Adjuvant Machine Translated by Google Esophageal sarcoma carcinosarcomas Finding; Dysphagia Aspiration pneumonia Airway obstruction, tracheoesophageal fistula Unlike carcinomas Remains on the muscularis propria It metastasizes less to lymph nodes Diagnosis Barium esophagus X-ray Endoscopy Machine Translated by Google Esophageal sarcoma carcinosarcomas Histological type Epidermoid (Epidermoid carcinoma) Mesenchymal Leiomyosarcoma, fibrosarcoma rhabdomyosarcoma Treatment Surgical resection There should be no wall invasion and LAP. Size is not an inop criterion RT success is low Machine Translated by Google Esophagus is benign allynopagan- Leiomyoma also · in young pol Most common benign tumor (50%) Smooth muscle origin Lower thoracic (lower 2/3) 10% of GIS leiomyomas 20-50 years old –male Symptom: Dysphagia Pain Bleeding is rare Machine Translated by Google Esophagus is benign Diagnosis Barium esophagus X-ray Regular filling defect with distinct edges Movable with swallowing Endoscopic USG (definitive diagnosis) CT (definitive diagnosis) Endoscopy For the distinction of simultaneous carcinoma Biopsy is not performed Treatment Risk of malignancy Enucleation (Thoracotomy-Endoscopic) Machine Translated by Google Machine Translated by Google Which of the following is the most common benign tumor of the esophagus? question about 30 dka Lipoma 32 : modes & be Adenoma > - if tur > - Suspicion sik gerten - SCC-en Leiomyoma obgerophagien > - rathe dysphagia Papilloma Hemangioma