Colon interposition versus esophagogastrostomy for esophageal carcinoma

Thirty-eight patients underwent either a colon interposition (18 patients) or an esophagogastrostomy (20 patients) for cancer of the distal two-thirds of the esophagus. Both procedures had essentially the same 30-day mortality (22% versus 20%), a similar major complication rate (78% versus 75%), and recurrent dysphagia rate (17% versus 15%). The lowest complication rate was seen in the colon interposition for cure (33%), as compared to esophagogastrostomy for cure (70%). The longest average survival time (14.6 months) was seen after a colon interposition for cure, with 33 per cent of patients alive at two years, compared to 12.4 months average survival and 30 per cent alive at two year seen in the esophagogastrostomy for cure group. There were no five-year survivals. Preoperative radiation appeared to have a beneficial effect regardless of tumor cell type or operative procedure. Surgical management of esophageal cancer appears to be palliative in most instances, regardless of operation performed.