title: Gastro-esophageal isoperistaltic bypass in the palliation of irresectable thoracic esophageal cancer.
abstract: METHODS
  The authors retrospectively review 22 patients with irresectable esophageal cancer in whom an isoperistaltic substernal gastric esophagogastric bypass was performed.
  
  
  RESULTS
  After the operation eighteen patients (82%) regained normal swallowing. Seven patients developed anastomotic stenosis that was successfully treated in six by surgery or endoscopic dilatation. Two patients evolved with cervical fistulae until their death. As a whole, there was a statistically significant improvement in swallowing capability (p = 0.0352). Seventeen patients (77%) had postoperative complications, the most common being cervical fistulae (in 13.59%), pneumonia (in 10.45%) and anastomotic stenosis (in 7.32%). Postoperative morbidity was significantly associated with preoperative diseases and ASA class III (p < 0.05). There were three postoperative deaths (14%). Postoperative mortality was significantly related to severe malnutrition and preoperative associated disease (p < 0.05).
  
  
  CONCLUSIONS
  The conclusion is that the procedure has acceptable morbidity and mortality for the population under consideration, permitting palliation of dysphagia in the majority of cases.
authors.affiliation: Department of Abdominal Surgery, Hospital A. C. Camargo, Sao Paulo, Brazil.
authors.forename: P S
authors.initials: PS
authors.lastname: Alcantara
authors.forename: F A
authors.initials: FA
authors.lastname: Spencer-Netto
authors.forename: J F
authors.initials: JF
authors.lastname: Silva-Júnior
authors.forename: L A
authors.initials: LA
authors.lastname: Soares
authors.forename: W M
authors.initials: WM
authors.lastname: Pollara
authors.forename: R G
authors.initials: RG
authors.lastname: Bevilacqua
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000601:surgery*; D003680:Deglutition Disorders / Q000209:etiology / Q000601:surgery; D004938:Esophageal Neoplasms / Q000150:complications / Q000601:surgery*; D004947:Esophagus / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008722:Methods; D008875:Middle Aged; D010166:Palliative Care; D011183:Postoperative Complications; D012189:Retrospective Studies; D013270:Stomach / Q000601:surgery*; D016896:Treatment Outcome