RESULTS OF ESOPHAGEAL RESECTION OF CARCINOMA OF THE ESOPHAGUS AND CARDIA

Surgery for carcinoma of the esophagus and cardia represents potential ly curative therapy in the early stage of the tumor. In the advanced s tage of tumor, palliation is the only remaining therapeutic aim. In a retrospective study covering the period 1984-1992 we analyzed 51 patie nts who underwent surgery for esophageal or cardia cancer to determine whether palliation by surgery is feasible. We also analyzed mortality and morbidity of peri- and postoperative complications. In 88% we car ried out standard esophagectomy consisting of abdomino-thoracal access , gastric interposition with thoracal anastomosis and extramucosal pyl oromyotomy. In the light of postresection histology, 53% of the operat ions were potentially curative (UICC stage I and II) and 47 palliative (UICC stage III and IV). Perioperative 30-day mortality was nil, and perioperative 30-day morbidity 11% (3 patients developed pneumonia pos toperatively, 2 patients with cervical anastomosis developed dehiscenc e of anastomosis which in both cases healed completely with conservati ve therapy, while a further patient with cervical anastomosis suffered persistent paralysis of the recurrent nerve. All patients were fully able to feed themselves at the time of discharge. 43% of patients had recurrent dysphagia and 24% underwent endoscopic dilatation. Three-yea r survival was 26%. From these results it may be concluded that esopha geal resection represents good palliation with low morbidity for the m ajority of patients with non-resectable carcinoma of the esophagus.