title: A twenty-year experience with surgical management of carcinoma of the esophagus and gastric cardia.
abstract: Twenty years of experience with operative treatment of carcinoma of the esophagus and cardia are reviewed. Of the 513 patients with biopsy-proved malignancy reviewed, 211 (41%) underwent gastroesophagectomy. The hospital mortality rate for the patients operated upon was 12%. The 3 year survival rate was 26% and the 5 year survival rate was 15% for the entire surgical series. Squamous cell carcinomas of the lower third were the most favorable subgroup (25% 5 year survival) and lower third adenocarcinomas the least favorable (8% 5 year survival). Our procedure of choice is a one-stage resection with stomach used to restore continuity. Operative details and perioperative management are reviewed. The single-layer wire technique of anastomosis seems to give acceptably low rates of anastomotic leak (4.2%) and stricture (2.3%). Preoperative radiation was not used in this series.
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery*; D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D002299:Cardia / Q000601:surgery*; D003106:Colon / Q000637:transplantation; D004931:Esophageal Achalasia / Q000601:surgery; D004938:Esophageal Neoplasms / Q000601:surgery*; D004944:Esophagoplasty; D005260:Female; D006551:Hernia, Hiatal / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality; D014182:Transplantation, Autologous