[Progress in oncological visceral surgery--esophageal carcinoma]

Compared to adenocarcinoma of the esophagus (Barrett cancer) the prevalence of esophageal squamous cell cancer is decreasing. Patients with squamous cell cancer have a less favorable risk profile for surgical therapy, a higher prevalence of lymphatic spread in early tumor stages, and more frequently an invasion of lymphatic vessels (lymphangiosis carcinomatosa) than patients with adenocarcinoma. A transthoracic en-bloc esophagectomy is therefore the procedure of choice for squamous cell esophageal cancer. The prognosis after surgical resection is worse for squamous cell esophageal cancer as compared to adenocarcinoma. In patients with early Barrett cancer a limited surgical approach is possible. The results of radical transmediastinal esophagectomy compare favorably to transthoracic esophagectomy in patients with locoregional Barrett cancer.