Distal-end esophagostomy of the excluded esophagus in the palliation of upper and mid-esophageal carcinoma.
The gastric bypass of the excluded esophagus in the palliative treatment of carcinoma of the esophagus carries a considerable mortality. One of the most significant events that contributes to this mortality is the disruption of the distal closure of the excluded esophagus. In order to avoid this, a distal-end esophagostomy accompanying the gastric bypass procedure was created in six patients with advanced carcinoma of the upper and middle third of the esophagus. This distal esophagostomy is carried out by extrapleural dissection and is developed to the back, at the level of the eighth rib, just lateral and adjacent to the spinal muscles. Operative survival of all these sick patients proves this to be a safe operation that avoids the fatal complication described.
Department of Surgery, Mayaguez Medical Center Consortium, University of Puerto Rico.
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G
Ramirez Schon
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Cebollero Marcucci
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Marquez Toro
D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000601:surgery*; D004947:Esophagus / Q000601:surgery*; D015390:Gastric Bypass; D006801:Humans; D008297:Male; D008722:Methods; D009367:Neoplasm Staging; D010166:Palliative Care / Q000379:methods*; D011379:Prognosis; D013529:Surgical Wound Dehiscence / Q000517:prevention & control; D015996:Survival Rate