OESOPHAGEAL & GASTRIC CARCINOMA;

Objectives: To know the frequency of gastroesophageal carcinoma andits management at Isra University Hospital Hyderabad Sindh. Study Design: Descriptive,Prospective. Place and Duration of Study: Isra University Hospital Hyderabad during the periodof January 2014 to January2016. Patient and Methods: Fifty two patients with gastroesophagealmalignancy were scrutinized for elective and emergency surgery according to the stage andtumor resectability & observed for postoperative complication rate. Data is prepared in SPSSversion 17. Inclusion Criteria: Carcinoma of esophagus and stomach. Exclusion Criteria:Benign lesions of esophagus and stomach (Tuberculosis, Bourevet’s syndrome, Band ofLadd’s, Diaphragmatic Hernia, Phyto/Tricobezoar). Gastric outlet obstruction (GOO) causedby bilio pancreatic, retroperitoneal or abdominal wall mass. Results: Among fifty two patients11(22%) were with carcinoma of esophagus and 41(78%) with carcinoma stomach causingGOO; accounting 38(73%) male & 14(27%) females with age range of 29-69 years. Majorpresenting complaints of carcinoma of esophagus were progressive dysphagia from solid toliquid with significant weight loss while history of heamatemesis was found in only two patients.Carcinoma stomach mainly presented with symptoms of gastric outlet obstruction (GOO);partial or complete I.e. vomiting, fullness and epigastric mass with weight loss. Out of total 52patients; 35 were biopsied and staged preoperatively while 17 patients could not be biopsiedbefore surgery either because of inadequate tissue specimen or scope negotiation problem.However after surgery their biopsy was found out malignant. All such patients were optimizedbefore surgery for correction of hemoglobin, electrolyte imbalance and nutritional supportFeeding jejunostom & gastrojejunostomy were mainly performed for carcinoma esophagus andstomach while for resectable tumors Ivor Lewis, McKeon or Billroth I or II were also performedaccording to the general patient condition and the local resectability of the tumor mass. Ourpost-operative complication rate was 26% and comprised nausea, vomiting, wound infection,and delayed gastric emptying which were treated conservatively. Our operative mortality wasnone. Conclusion: Most of our cases were in advanced stage of malignancy which was mainlydealt with Feeding jejunostomy & Gastrojejunostomy. However Esophagogastric intubation inadvanced malignancy is the safe & effective alternative if available.