ESOPHAGEAL CANCER
Contrary to what is a common belief cancer is as common in Ethiopia as in the rest of the world. One form of cancer frequently seen here at Aira Hospital is cancer of the esophagus. The reason for the high incidence is not known. Some believe that the smoke inside the huts from the cocking fire has an implication. Other blames the intake of hot tea or spiced foot.
The diagnosis is usually obvious at a glance. The patient complains of increasing dysphagia for solid foot and later even liquids and is elderly and most often cachectic (severely undernourished). When asked where the foot is getting stuck the patient can make an exact point to the location of the occluding malignancy.
When the patient is already cachectic there is no use of doing surgery as the prognosis is pessima (hopeless). One could make a palliative resection or by pass, but the survival rate is very short and the expenses for the treatment will only make an extra burden to the family who might sell their only cattle and put themselves into debts to raise funds for the treatment.
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Only if there is a reasonable chance that the patient might be cured should one proceed with surgery – resection of the esophagus and intrathoracic anastomosis with a mobilized stomach
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Mobilizing the esophagus |
Mobilizing the esophagus |
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Cutting the esophagus above the cancer |
Mobilizing the stomach through diaphragm |
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Cut end of esophagus |
Mobilized stomach |
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Anastomosis |
Anastomosis |
