Article Published In Vol.7 (Nov-Dec-2019)

To Study the Correlation of Imaging and Resection Margin in Determining the Post Operative Morbidity and Mortality in Oesophagealgastric Juction Tumour

Author : Dr.S. Anbazhagan, MS.; Dr.P.Ganesh Kumar, MS. and V.S.Iniyan

Obective:1. To study the radiological correlation in operability of the tumors; 2. To study the length of resection margin pre operatively and marginal status in histopathological examination; 3. To study postoperative morbidity and mortality.
Methods: The patients with GE junction tumors complaints are admitted and evaluated. The evaluation process begins with careful history taking and clinical examination. Comorbid illness is encountered in each patient and evaluated accordingly. Later, these patients are investigated. The main investigations includes: Contrast radiogram; OGD scopy; Contrast enhanced computed tomography chest and abdomen; USG abdomen
The above said investigationsgives tissue diagnosis and helps in staging the disease. According to the stage the treatment is planned. The operable patients are approached with operative procedure with curative intent or to attain locoregional control. The procedure commonly done are transhiatal esophagectomy with reconstruction and total gastrectomy. In inoperable patients, the palliative procedure like feeding gastrostomy, feeding jejunostomy,etc are done. The patients are classified according to Siewert’s classification from the investigations and proceeded accordingly. OGD scopy gives macroscopic appearance and tissue diagnosis for histopathological examination. CECT abdomen and thorax and USG abdomen helps in staging and metstatic work up of the disease.
Results: The common OGD scopy findings of type of lesions are ulceroproliferative (59.64%) and ulceronodular (19.29%). Significant percentage of patients (38.6%) present with metastasis. The common site of metastasis are liver (59.09%) and lung (45.45%). The common postoperative complications are respiratory complications (26.7%), wound infection (26.7%) anastomotic related problem (20%). The early postoperative mortality rate is 6.7%

Keywords: Esophagealgastric junction tumor, operability, metastasis