Read about an innovative method for a rare esophageal cancer treatment in Santa Maria Di bari hospital in Italy.
Santa Maria Hospital
An extensive tumor of the esophagus afflicted a 58-year-old patient from Naples. Given the extend of the neoplasm, the patient has been deemed inoperable by other specialists to whom he had turned but, after a careful evaluation of the clinical picture, the surgical team of the Santa Maria di Bari hospital led by Dr. Antonio Braun developed the surgery that allowed the tumor to be removed.
The patient, a smoker (cigarette smoke is one of the main causes of esophogeal cancer), was experiencing significant progressive weight loss, difficulty in ingesting solids and subsequently also liquids. The gastroscopy had found a 12cm neoplasm of the distal portion of the esophagus (the one closest to the stomach) which also infiltrated the cardia, or the junction between the esophagus and the stomach. the tumor had completely narrowed the esophagus so much that the patient was almost no longer able to eat or drink, leading him to anemia.
“Esophageal cancer is a rare neoplasm, there are 3 cases per 100,000 inhabitants. it has a fairly aggressive behavior, precisely due to the anatomical structure of the esophagus itself”, explains Dr. Antonio Braun.
Previously, the patient has undergone a one-month cycle of preoperative chemotherapy, which however had no result either in reducing the volume of the tumor or in relieving the symptoms.
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The Esophagectomy Technique According to Ivor Lewis
Ivor Lewis esophagectomy, the gold standard for the treatment of disal esophageal cancer, involves a double surgical approach, transthoracic and abdominal. this procedure allowed the radical removal of the tumor and above all the restoration of the patient’s digestive continuity, to allow him an independent and regular diet, which can be achieved gradually.
The operation extremely complex due to the spread of tumor, lasted 5 hours. the team adopted the technique according to Ivor Lewis because it is minimally invasive and particularly suitable for treating tumors in this site. the operation took place in two stages during the same operation: the first stage by laparoscopy to tubulize (resection of a vertical section) the stomach and remove the abdominal lymph nodes involved in the pathology. the second part of the operation via thoracoscopy , allowed the tumor to be removed and an anastomosis to be performed, i.e reconnecting the remaining esophagus to the stomach.
the minimally invasive access allows for a faster postoperative recovery compared to the 15-20 days required with the traditional method. thanks to the application of recent clinical protocols(“fasHrack” and “ERAS”) after a day in intensive care while awake, the patient returned to the ward and the nasogastric tube was removed, after two days he resumed drinking independently. furthermore, mobilization took place on the second day, the abdominal and thoracic drains were removed on the 3rd and 5th postoperative days, respectively. the patient was discharged after 8 days.
GVM Health Group
Founded in 1973 with the inauguration of its first private healthcare facility, today, GVM Care & Research is a Group offering medical and scientific excellence at 49 structures located not only in Italy, but also in France, Albania, Poland and Ukraine. It is also the foremost Italian Group as regards territorial extension, employing over 9,000 people with the aim of placing patients at the centre of an integrated network of state-of-the-art healthcare facilities. This aim has been achieved with advanced technologies, highly comfortable environments and professionals with constantly updated international experience.
Over the ensuing years GVM Care & Research broadened its field of action by taking over further facilities and creating companies complementary to its healthcare business, going into such sectors as medical-scientific research and training, wellness and spa treatment, hotel hospitality, the biomedical industry, food products and services to companies. In 2007, the Group began to expand beyond the Italian borders, not only with numerous acquisitions and inaugurations, but also with major investments in the social-welfare services.
As a result of its business accomplishments and its extensive experience gained in the word of healthcare, GVM Care & Research keeps capital of expertise with high added value not only in the medical field but also in terms of design, organization and management of Hospitals until providing “ready-to-use” facilities in Italy as well as abroad.