[Therapy of esophageal carcinoma--surgical procedures].

Abstract

Transthoracic and transmediastinal resection without thoracotomy are the two possible surgical procedures for treatment of esophageal carcinoma. The transmediastinal procedure lends itself particularly for carcinomas in the distal part of the esophagus. The indication for operation is based on an exact preoperative tumor-staging. Primary surgery is only indicated, when R0-resection seems possible. Otherwise multimodal therapeutic concepts and palliating treatment should be preferred. The extent of lymphadenectomy, standard-lymphadenectomy, two-field- or three-field-lymphadenectomy are currently disputed. Extensive lymphadenectomy seems to yield significantly better prognosis in early esophageal carcinoma. The importance of multimodal therapeutic concepts is not yet sufficiently defined. Further studies are needed.