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PATOLOGIEESOFAGIAN

Prof. Dr. Brtucu E.

Curs 2

Esofagita postcaustic

Cancerul esofagian

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ESOFAGITA POSTCAUSTC

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Esofagita postcaustic

Subst. alcaline -> leziuni mai profunde

Subst. acide -> necroz de cuagulare

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Faze

Necroz acut -> 1-4 zile

Ulcerare i granulare -> 5-12 zile

Cicatrizare -> peste 12 zile

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Simptome

Durere retrosternal

Disfagie total

Hipersalivaie

Febr

Sngerare

1-2 luni -> interval liber asimptomatic

DISFAGIE PROGRESIV

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Cancerul Esofagului

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Anatomia

esofagului

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Cancerul esofagului

Forme histologice

Carcinom scuamos

adenocarcinom

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Cancerul esofagului

Chromozom 17P -> mutaii gena supresoare p53

Antigen carcinomscuamos - 50%

Factorul de cretere epidemic

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Clinica

Disfagia progresiv

Tulburri de fonaie

Hipersalivaie

Tulburri respiratorii

Adenopatii

Metastaze

Scadere ponderal

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Diagnostic paraclinic

Prnz baritat

Endoscopie + Echo + Citologie

CT

Toracoscopia

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Tratament multidisciplinar

20% supravieuire la 5 ani

oncolog

radioterapeut

chirurg

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Stadializare

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Tratament

60% stadiile 0 - II -> chirurgie radical curativ

40% stadiile III - IV -> tratament paleativ

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Chirurgie radical

Esofag cervical

esofagiectomie total

laringiectomie

faringiectomie parial

Esofag toracic 1/3 sup + 1/3 medie

esofagiectomie toraco - abdominal

Esofag toracic inferiori abdominalesofagiectomie inferioar

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Esofagiectomie

total+

laringiectomie

(piesa operatorie)

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Restabilire tranzit

Esofagoplastie

colon

stomac

jejun

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Tratament paleativ

Intubaie endoscopic a tumorii

repermeabilizarea tumorii

radioterapie extern, brahiterapie

chimioterapie

gastrostomie

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Laser terapie

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