Esophagogastrectomy for adenocarcinoma of the cardia. Ten years' experience and current approach

J. E. Molina, B. R. Lawton, W. O. Myers, E. W. Humphrey

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36 Scopus citations

Abstract

During a 10-year period, 94 surgical resections for adenocarcinoma of the cardia (75 'curative' and 19 palliative) were performed using three primary approaches: Group I (46 curative, 14 palliative), esophagogastrectomy performed through a left thoracotomy or left thoraco-abdominal incision; Group II (17 curative, 4 palliative), resection done through two separate incisions (abdominal and thoracic) with delayed reconstruction between two and three months later; and Group III (12 curative, 1 palliative), resection, also through abdominal and thoracic incisions, with simultaneous reconstruction. Operative mortality in the 75 procedures done for cure was 19.5%, 18%, and 8.3% in Groups I, II, and III, respectively. Microscopic residual tumor at the line of resection was 56%, 12%, and 8%. Free margins <3 cm had the same local recurrence rate (21%, 6%, and 8%) within 18 months as did margins with residual microscopic tumor. The length of time from operation to first regular meal was 12, 110, and 7 days, respectively. Wide resection with subtotal esophagectomy and simultaneous reconstruction is advocated.

Original languageEnglish (US)
Pages (from-to)146-151
Number of pages6
JournalAnnals of surgery
Volume195
Issue number2
DOIs
StatePublished - 1982

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