Surgical treatment of esophageal carcinoma with cervical esophagogastrostomy by left thoracic esophagectomy

Objective To evaluate the effects of surgical treatment with cervical esophagogastrostomy by left thoracic esophagectomy on esophageal carcinoma. Methods The clinical data of 3169 patients with esophageal carcinoma, 2115 males and 1054 females, aged 60.9 (30 -82), that underwent cervical esophagogastrostomy by left thoracic esophagectomy from Jan. 1990 to Dec. 2000 were analyzed retrospectively. Results The incidence of complication was 8.6% (273). The operative mortality was 0.6% (19). The 1, 3, and 5 year survival rates were 81.5%, 51.6% , and 32. 1% respectively. Manometric examination of the digestive tract showed that the post-operative resting pressure of residual esophagus above the anastomotic stoma was ( 16±11 mm Hg), significantly higher than that of the cervical esophagus of the normal controls [(4±3) mm Hg), P <0.01]. Conclusion Reducing incidence of gastroesophageal reflux and improving the quality of life of patients, cervical anastomosis should be recommended as the first choice procedure in treatment of upper and middle segment esophageal carcinoma. Key words: Esophageal neoplasms;  Esophagectomy;  Anastomosis, surgical;  Gastroesophageal reflux