[Reflux disease and cancer]

The malignant potentiality of endobrachy-oesophagus and other organic forms of reflux disease amounts to ten per cent, according to experience obtained by the author of this paper and examiners elsewhere. Two thirds of the neoplasias were found to be located in the distal part of the oesophagus and one third in the centre. Lasting reflux and gradual transition to dysphagia were recorded only from 50 per cent of all cases. The author's approach to operable cases is abdomino-thoracal. Decisions on operability and radicality are usually based on laparotomy. The stomach is mobilised and, following removal of the tumour, is moved up as high as possible to the right thoracic cavity where it is anastomosed to the proximal oesophageal stump. The author analysed his patients under all relevant aspects and summarised in tabulated form classifications, origins, operability, and results. Early surgical treatment of aggressive reflux disease (abdominal fundoplication or complementary vagotomy, depending on acid potential) may reduce but not completely eliminate the risk of malignant degeneration. Preventive removal of endobrachy-oesophagus is not justifiable for the high biological price involved.