[Standardized surgery of esophageal cancer]

Surgery was performed in 63 out of 143 patients admitted with oesophageal carcinoma (44%) between 1977 and 1983. The tumour-affected oesophagus was resected in 47 patients (33%). For resection the abdomino-thoracic approach with removal of the oesophagus under sight was done in 26 patients, blunt transmediastinal oesophageal dissection in 21 and palliative gastric bypass without tumour removal in 16 patients. The mortality in the group with abdomino-thoracic resection was 31%, in blunt resection 10%, and in gastric bypass 12,5%. The main cause of mortality was pulmonary complications. As the mean survival time after blunt dissection is not different from the one after abdomino-thoracic resection the former is considered as method of choice due to the lower mortality. Abdomino-thoracic resection should be reserved only for a few patients with stringent indication.