Abdominocervical oesophagectomy in the elderly.

Abdominocervical (transhiatal) oesophagectomy was carried out in 8 patients. Five of 6 with oesophageal cancer were elderly (aged 75-88 years), and one was 59 years old. Two patients (aged 54 and 74 years) had recurrent achalasia and megaoesophagus 30 years after cardiomyotomy. Chest complications were common, but there were no anastomotic leaks and no deaths. In 2 patients with large paraoesophageal hiatal hernias oesophagectomy had not been planned; the procedure was undertaken for an unexpected carcinoma of the cardia and an oesophageal tear. Three patients have died of recurrent cancer at 12, 17 and 21 months. The 5 survivors are swallowing satisfactorily, although one has required two dilatations of an anastomotic stricture.