Factors influencing morbidity and mortality in esophageal carcinoma

In 1977, 152 patients with carcinoma of the esophagus were admitted under our care. The lesions were located from the hypopharynx to the cardiac portion of the stomach. A prospective study was conducted and the results (mortality and morbidity) were analyzed by computer. Resection was possible in 88 patients and a bypass procedure in 15. On exploration in five patients, the disease was found to be so extensive that no further operative procedures were undertaken. The mortality rate was high, hospital deaths being included in the operative mortality statistics. The best results were obtained by applying the Lewis-Tanner one-stage esophagectomy. When the disease was extensive, a bypass procedure using the Kirschner operation and postoperative irradiation was the method of choice. When the general condition of the patient was poor, the best procedure was a staged esophagectomy, with the reconstruction being undertaken at a later date.