[Cervical esophago-gastrostomy via the posterior mediastinal route for carcinoma of the thoracic esophagus].

From 1981 to 1990, 297 cases of carcinoma of the thoracic esophagus were resected in our department. Among these cases, 225 cases (84.3%) were reconstructed cervical esophagogastrostomy via the posterior mediastinal route. In this paper, these 225 cases were analysed to evaluate the usefulness of this procedure which was developed by S. Abo in 1975. Operative mortality was 4.4% Anastomotic leakage occurred in 24.4% of the cases, but the majority of the cases were treated successfully without any drainage and 83.3% of the cases could start their diet within one month after operation. The volume of oral intake by the patients after discharge increased satisfactorily (1,500-1,800 kcal/day), but the body weight decreased gradually. So the ambulatory enteral nutritional support was started and proved useful for maintaining their body weight. Alkaline reflux evaluated using 24-hour pH-monitoring system was observed in about half of the cases but the degree of the alkaline shift was not strong. Some complaints (heart burn in 6.3%, regurgitation in 21.9%, feeling of fullness after eating in 40.6%, stenotic sensation in 20.7%) were present but not serious.