Radically remove cancer and reconstruct the esophagus for patients

Besides heartburn for many days, Mr. Duc had no other typical symptoms. When he went to Tam Anh General Hospital in Ho Chi Minh City for examination, the endoscopy doctor discovered a lesion in the lower esophagus. The results of a 3 Tesla MRI and 1975 CT scan showed that the lesion was still in an early stage, had not invaded or infiltrated the surrounding area, and no abnormally enlarged lymph nodes were noted.

On October 30, Dr. Do Minh Hung, Director of the Center for Gastrointestinal Endoscopy and Surgery, said that Mr. Duc had squamous cell carcinoma (epidermal cells in the wall of the esophagus). ). The patient was assigned to have three-phase laparoscopic surgery (three stages) including chest, abdomen and neck. The doctor cuts the patient’s entire esophagus to prevent cancer cells from spreading, then shapes this part with a stomach tube inserted into the neck to connect to the esophagus.

Esophagectomy surgery is complicated, care must be taken to avoid affecting surrounding important organs such as the heart, lungs, and recurrent nervous system to reduce the risk of complications.

Starting in the thoracic phase, the doctor dissects and moves the esophagus, scrapes nearby lymph node groups, and preserves the right recurrent nerve. Next, the surgical team performed surgery on the neck and abdomen at the same time, releasing the ligaments around the stomach to move the greater and lesser curvatures of the stomach, cutting the stomach in a tube shape, suturing the two ends of the esophagus – stomach. After that, the team cut open the muscle, sewed up the pylorus, and opened the jejunum for feeding. The team of doctors operated on the neck and simultaneously dissected the cervical esophagus, inserted the stomach tube into the neck to connect with the esophagus, and sewed up the connection.

The patient recovered well, was alert, could walk normally, and was discharged from the hospital after 5 days. He ate with a jejunostomy for another week, waiting for the new esophagus to stabilize.

Because the cancer is in the early stage and has not metastasized, Mr. Duc does not need additional treatment and has a good prognosis. But according to Dr. Hung, cancer cells can recur in the first 5 years, patients need regular check-ups.

Common signs of esophageal cancer are choking, difficulty swallowing when eating, gastric reflux, hoarseness, prolonged cough, unexplained weight loss… The disease is often detected in the late stages, when Symptoms are clear, the cancer has spread, making treatment difficult and the prognosis is quite poor.

“About 25% of esophageal cancer cases are detected in the early stages,” Dr. Hung said, adding that patients with stage one esophageal cancer are treated promptly, with a high survival rate of over 5 years. In cases where cancer spreads to nearby structures and metastasizes to other organs, the 5-year survival rate decreases.

Treatment effectiveness depends on physical condition, accompanying diseases, method, patient’s ability to respond… Some cases have a better prognosis than expected. Patients should stay optimistic, follow the doctor’s treatment instructions and live scientifically for optimal effectiveness.

Dr. Minh Hung recommends regular health check-ups. People with high risk factors such as a history of prolonged esophagitis, gastroesophageal reflux, Barrett’s esophagus, past gastrectomy or atrophic gastritis should be screened for cancer periodically. You should eat scientifically, live a healthy lifestyle, and avoid abusing stimulants such as alcohol and tobacco.