Prof Sanjay Sharma is Secretary of Indian society of disease of esophagus. Dr Sharma had training for esophageal cancer management from different institutes namely
Tata Memorial hospital, Mumbai, for 27 years, were Dr. Sanjay Sharma was also Head of Thoracic surgery department from 1998 to 2003.
Memorial solve catherine cancer hospital USA in year 1993 (observer).
Department of esophageal surgery at Kurume Medical University, Japan. Special training in esophageal cancer surgery in the year 1991.
Training for esophageal cancer as observer for 4 weeks with Dr. David Skinner at Newyork & Cornhell university, USA in year 1989 and 1991.
Dr. Sanjay Sharma has learned radical three field total esophaectomy from Japan. Dr. Sanjay Sharma was first to start the radical three field total esophaectomy in India, in the year 1992. Dr Sharma has performed more than 300 radical three field total esophaectomy such selective cases till now with excellent result. In last 10 years numbers of cases operated with radical three field total esophaectomy were 275.
Conparision of Results of Dr Sanjay Sharma
| Evidence for three field lymphadenectomy – Prospective / Retrospective studies |
| |
Overall |
Node Positive |
Node Negative |
| Altorki et al 2002 n=80 |
51 % |
33 % |
- |
| Fujita at al 1997 n=90 |
54 % |
- |
- |
| Ando et al 2000 n=419 |
40 % |
25 % |
68 % |
| Osugi et al 2002 n=247 |
50 % |
N 1-3 - 47.5%
N>4 -15 % |
- |
| Sharma et al 2003 n=264 |
54.5% |
41% |
87 % |
Comparision of Ca Esophagus
Recurrence Rate
| |
Groups |
Patients |
Locoregional Recurrence |
Survival |
| Akiyama et al |
3F |
210 |
11.4% |
53% |
| Lerut et al |
3F |
38 |
17.6% |
45% |
| Fujita et al |
3F |
90 |
30% |
54% |
| Sharma et al |
3F |
264 |
8% |
54.5% |
| Altorki et al |
3F |
80 |
9.7% |
51% |
| Orringer et al |
THE |
417 |
39% |
27% |
| Desai et al |
Ivor-L |
630 |
33% |
25% |
Ca Esophagus
Mortality and Morbidity
| Mortality |
Morbidity |
| Pulmonary |
RLN Plasty |
Leak |
Tracheostomy |
| Akiyama 1994 |
2% |
31% |
10% |
0% |
- |
| Fujita et al 1995 |
2% |
6% |
70% |
11% |
21% |
| Kato 1991 |
2.6% |
9% |
14% |
33% |
- |
| Nishihara 1998 |
3.1% |
19% |
56% |
6% |
53% |
| Altorki 2002 |
5% |
26% |
9% |
11% |
4% |
| Ando 2000 |
1.7% |
22% |
- |
13% |
- |
| Sharma et al 2009 (264) |
3% |
18% |
12.5%
30% T |
2.6% |
7.5% |
Survival for three field lymphadenectomy – Prospective / Retrospective studies
| |
Overall |
Lymphnode Positive |
Lymphnode Negative |
| Altorki et al 2002 n=80 |
51% |
33% |
- |
| Fujita at al 1997 n=90 |
54% |
- |
- |
| Ando et al 2000 n=419 |
40% |
25% |
68% |
| Osugi et al 2002 n=247 |
50% |
N1-3 -47.5% |
- |
| Sharma et al 2009 (264) |
54.5% |
41% |
87% |
In last 100 cases of radical three field total esophaectomy
| Mortality |
0% |
| Leak rate |
0% |
| Node Negative Patients |
89% |
| Node Positive patients |
42% |
Thus giving an overall survival of the entire group to 55% at end of 5 years.
This morbidity is minimal and expected.
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