A 62-year-old patient has been suffering from heartburn and upper abdomen discomfort for the last 12 months. He was investigated outside and during upper GI endoscopic examination, diagnosed to have a growth in the mid of the oesophagus. He had taken treatment outside in Bhopal for the same and received chemotherapy as well as radiation. After completion of the treatment, the patient visited surgical oncology OPD at AIIMS Bhopal with the similar discomfort. After clinical and radiological examination in AIIMS Bhopal it was found that disease was limited to oesophagus and operable and the decision to proceed with surgery was planned by Dr. Neelesh Shrivastava, Assistant Professor Department of Surgical Oncology AIIMS Bhopal for the patient cure.
The surgery was challenging in view of old age and especially location of disease in the mid of the chest. Patient was optimized before surgery by lung exercised and protein supplements and after 10 days of optimization he was taken up for surgery .Patient was kept on one lung ventilation during surgery and successfully operated by the team headed by Dr Neelesh Shrivastava, Dr Sonveer Goutam, Senior Resident and Dr Harish Kumar, Associate Prof Anaesthesia. Surgery was completed in 9 hours. After removal of the oesophagus the continuity of the digestive tract was again maintained by making a pipe by stomach and attached it to remaining oesophagus. Post operatively he was managed well by Dr Sourabh Sehgal, Additional professor in critical care ICU for 3 days.
This is to notify you that an oesophageal tumor is a very common tumor and generally it seems to undiagnosed until it reaches to advance stage. Although it is controllable with chemo radiation followed by surgery .Triple phase esophagectomy for such type cancers is a lengthy surgery and needs special cancer surgery training to deal such cases. In this procedure first the thorax have to open and diseased part of oesophagus have to be removed. Later, abdomen is opened and stomach is modified in a tube shape to mimicking it like an oesophagus and lastly this tube have to pass via thorax to neck where it is joined with remaining oesophagus. This procedure was carried out by the surgical oncology department of AIIMS Bhopal under the guidance of Dr.Vinay Kumar, Head of the department of Surgical Oncology. The patient is now doing well and discharged. Such type of complex surgeries is now routinely done by surgical oncology department in AIIMS Bhopal. Executive Director, AIIMS Bhopal Prof. (Dr) Ajai Singh has congratulated the team for this achievement.