Functional results following esophagogastrectomy for carcinoma of the esophagus

Fifty patients underwent esophagogastrectomy for histologically proven carcinoma of the esophagus from January to December 1989. The Ivor Lewis procedure was performed in 29 patients and 21 resections were performed by a left thoracoabdominal approach. There was one anastomotic leak which could not be salvaged and was responsible for the sole mortality within 30 days of surgery. The hospital stay averaged 12 days, ranging from 8-26 days. Swallowing was resumed by the 6th postoperative day for liquids and 8th day for soft solids. Following surgery, 5 patients developed dysphagia, 4 of whom responded to dilatation. The anastomosis was hand sutured in all cases except one. The suture material used had no relation to the incidence of leak or stricture formation. Eight patients complained of reflux that settled with medical management. Most patients were eating without dysphagia at the last follow-up or death. Esophagogastrectomy can be performed with a low morbidity and mortality and provides adequate palliation of the patient's most distressing symptom, dysphagia.