[Esophageal extirpation with one-stage esophagoplasty]

In the period from 1980 to June, 1989 the authors conducted operations on 128 patients for extirpation of the esophagus with one-stage esophagoplasty by means of an isoperistaltic tube formed from the greater curvature of the stomach. Fifty-four of these patients had benign esophageal strictures, 74 had malignant lesions of the esophagus. The authors claim this operation to be the operation of choice in carcinoma of the lower third of the esophagus and in carcinoma of the cardia extending to the thoracic esophagus. It may be carried out in carcinoma of the thoracic esophagus at any level, in benign strictures of the thoracic esophagus, and in stage IV cardiospasm in patients in whom operations had been performed earlier on the cardia. The abdominocervical approach can be supplemented by right thoracotomy in carcinoma of the midthoracic part of the esophagus. Four patients (3%) died after the operation. The authors recommend wider use of the operation.