Gastro-esophageal isoperistaltic bypass in the palliation of irresectable thoracic esophageal cancer.
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.
Alcantara
P S
PS
Department of Abdominal Surgery, Hospital A. C. Camargo, Sao Paulo, Brazil.
Spencer-Netto
F A
FA
Silva-Júnior
J F
JF
Soares
L A
LA
Pollara
W M
WM
Bevilacqua
R G
RG
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