[On the surgical treatment of esophageal cancer. Radical esophagus extirpation and colon interposition].

Abstract

The authors report and analyse their cases of carcinoma of the esophagus, excluding carcinoma of the cardiac region of the stomach, as seen at the Surgical Departments of both the University Hospitals of the Free University of Berlin and of the University of Heidelberg. In 468 cases the tumor site was found to be most frequently in the middle third of the esophagus. Males outnumbered fe males by a proportion of 1 : 5. Operative mortality totaled 30 per cent, as compared to 6 to 50 per cent in world literature. A five year survival after resection was reached by two patients only. In three patients, two carcinomas and one sarcoma, a total esophagectomy had to be performed with retrosternal interposition of colon between cervical esophagus and stomach. There was no immediate postoperative death, but all of these three patients succumbed to a metastatic spread of the disease within the second year after surgery. These cases are reported in detail. In conclusion the authors are pointing out that, in accordance with world literature, total esophagectomy with interposition of a segment of the colon does not ameliorate the fate of the patient with a carcinoma of the upper third of the esophagus.