Surgical aspects in the treatment of esophageal cancer.

In operation for esophageal cancer the authors distinguish amputation and rehabilitation stages. Analysis of survival rate has shown that extended esophageal resections are preferable to typical resections. The differences are significant both in locally limited cancer and cancer with lymphogenous metastases. One-stage esophagoplasty is advisable, since after Dobromyslov-Torek's operation multistage esophagoplasty could be completed only in one-third of the patients due to recurrence of the disease and their general weakness. In Lewis' and Garlock's one-stage operations it is preferable to perform an "end-to-side" anastomosis with immersion of the first line of anastomotic sutures and the adjacent esophageal part into the anterior gastric wall. Postoperative mortality for Lewis' and Garlock's operations was 14.7% and 8.3%, respectively. Combined operations are justified only when one-stage esophagoplasty is performed.