[Two stages three fields lymph node dissection in esophageal cancer]

In order to indicate the three fields lymph node dissection method to wider ranges of patients with esophageal cancer, the two stages technique was applied to those with moderate disturbance of general physical conditions. Fifty eight patients with esophageal cancer admitted to our clinic from January 1986 to December 1988 and 38, in whom those with cervical esophageal cancer were excluded, employed esophagectomy. Of them, 26 patients (68%) received the three fields dissection method, 13 being due to the one stage technique and the remaining 12 being due to the one stage technique and the remaining 13 being due to the two stages technique. The three fields dissection method was indicated to patients who were younger than 75 years of age, were expected to receive curative resections or had no, mild and moderate disturbances of the physical conditions. The one stage technique was applied to patients with no and mild disturbances of the physical conditions while the two stages technique was to those with moderate disturbance. The general physical conditions were evaluated with the past history, underlying diseases, functions of the main organs and the ability of host defense. In the first operation of the two stage technique, subtotal esophagectomy and dissection of the regional lymph nodes including the paratracheal ones were performed. After approximately one month, esophageal reconstruction with the gastric tube and dissection of the regional nodes of the abdomen and neck were done in the second operation.(ABSTRACT TRUNCATED AT 250 WORDS)