[Esophageal surgery in the regional hospital]

In a small series of surgically treated patients with esophageal cancer (n = 22) modern trends are observed, namely--the frequent occurrence of adenocarcinoma (50% of cases) and of early stage (pT1) (36% of cases),--a low operative mortality (5%),--favorable oncological results for tumors not penetrating the esophageal wall (pT1, 2)(64% of patients at life without recurrence 2-7 1/2 years after surgery). For curative or palliative resection of distal tumors the abdomino-cervical (transhiatal) resection was favored (n = 17) with no instance of anastomotic insufficiency and with 2 cases only of locoregional recurrence. In a case of spontaneous esophageal perforation (Boerhaave) primary suture through an abdomino-transhiatal approach was successful. The interdisciplinary intensive care, necessary in surgery of the esophagus, may be of a high standard in the district hospital.