[Results of surgical therapy of esophageal carcinoma]

In esophageal cancer radical resection of the affected segment is the therapy of choice for tumours confined to the wall. Palliative resection at advanced tumour stages does not improve survival and markedly increases mortality. Neither chemotherapy nor radiation influence the survival rates. Tumours of the middle third are resected by the thoracic approach, while tumours of the lower third may be resected by blunt dissection. The best reconstruction is achieved by interposition of the stomach. The jejunum or colon may be interposed in the case of a previous gastric resection. In our department, postoperative mortality was 8.8%, corresponding to 137 operations with stomach interposition. The 5 year survival rate was 39.9% in stage I and II and 10.6% in stage III and IV. Complications and mortality were markedly increased in advanced tumour stages. The thoracic approach was not correlated with higher postoperative lethality.