The forty patients with carcinoma of the esophagus or cardia seen at National Medical Center between November 1983 and April 1994 underwent surgical exploration. The esophagogastrectomy was carried out in 29 of 40 patients, one case through right
thoracotomy, the others through left thoracotomy. Two patients underwent colon bypass surgeries due to upper esophageal cancer. Transhiatal esophagectomy was performed in one case. Feeding gastrostomy or feeding jejunostomy were performed in 8
patients
due to the advanced stage or malnutrition. In this report, we evaluated the long-term results in the 28 patients who underwent esophagogastrectomy for palliation through the left thoracotomy.
There were 25 men(89%) and 3 women(11%), and the mean age was 58.65±7.15 years(range, 46 to 73 years). The most frequent preoperative symptoms included dysphagia(22), weight loss(15), chest pain(6), vomiting(1), and hoarsness(1), and
hoarsness(1).
Twenty-three patients had sqamous cell cancers of mid-and lower esophagus and five adenocarcionomas of cardia. One patient died in the hospital within 30 days of the operation for a hospital mortality rate of 3.7%. Cause of death was sepsis due
to
anastomotic leakage. There were five additional complications in five patients; acute respiratory distress syndrome(1), post-opertive bleeding(1), diaphragmatic hernia(1), acute renal failure(1) and late graft stenosis(1). The one year, two
vears,
and
three years acturial survival rate were 75.6±9.5%, 43.2±11.6%, 21.6±10.5% respectively. The average survival was 21.8 months. The data from this study suggest that esophagogastrectomy through the left thoracotyomy can achieve resonable
long-term
palliation for carcinoma of the esophagus. The operation can be performed with a low operative mortality and rew serious postoperative complications.
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