[A comparative study of cervical and thoracic anastomoses after esophagectomy for esophageal carcinoma]

From April 1979 to December 1984, esophagectomy was performed in 552 cases of esophageal cancer of which 108 received cervical anastomosis and 444 intrathoracic anastomosis. The total postoperative complications and operative mortality rates of the two groups were very close. Leakage was significantly more frequent after cervical anastomosis, but mortality due to leakage was less frequent than that in thoracic anastomosis. The 1-, 3-, 5-, 10-year survival rates of cervical anastomosis were apparently higher than those of intrathoracic anastomosis, but the differences were not statistically significant. The 5-year survival rates of patients with the same TNM stage failed to demonstrate any significant difference between the two groups. The quality of life among the groups was satisfactory. There was no deterioration of the quality of life in cervical anastomosis. It caused less gastroesophageal reflux than did intrathoracic anastomosis. We hold that esophagectomy with cervical anastomosis and extensive lymphadenectomy is a better treatment of choice for carcinoma of the esophagus.