[Long-term results following resection and esophageal reconstruction in esophageal cancer]

Between 1968 and end of 1981 162 patients, aged 30 to 77 years (mean 59,9 years) underwent esophageal resection and digestive tract reconstruction for carcinoma of the esophagus and cardia. There were 102 squamous cell- and 60 adenocarcinomas which were located in 8 patients in the upper thoracic third, in 67 patients in the middle third and in 87 patients in the lower thoracic third including the cardia. Esophago-gastrostomy was performed in 138 cases whereas colon was used in 18 and jejunum in 6 cases. Overall hospital mortality was 14.8% and was reduced to 9.4% during the period from 1976 to 1981. Survival rates at two years and 5 years were 31.8% and 5.6% resp. However, for patients with seemingly "curative" resections, i.e. when the carcinoma was limited to the esophageal wall and the lymph nodes were found uninvolved, these rates were 73.2% and 23.7% resp. Follow-up studies in 103 patients revealed typical functional sequelae such as anastomotic stenosis and reflux in less than 20% of the patients. The incidence of such symptoms was higher in patients with a low subhilar anastomosis than in patients with a high supraaortic anastomosis. It is concluded that esophageal resection and reconstruction of intestinal passage for carcinoma may significantly prolong survival and may warrant a fairly acceptable quality of life. More than 70% of the investigated long-term survivors were leading a normal life also resuming an improved nutritional status.