PMID: 7524974Dec 1, 1994Paper

Quality of palliation and possible benefit of extra-anatomic reconstruction in recurrent dysphagia after resection of carcinoma of the esophagus

Journal of the American College of Surgeons
J J van LanschotH W Tilanus

Abstract

After "curative" resection of carcinoma of the esophagus, late secondary dysphagia almost invariably indicates locoregional tumor recurrence. The retrosternal reconstruction route is advocated to prevent ingrowth of tumor recurrence in the neoesophagus. To evaluate the quality of palliation after "curative" resection of carcinoma of the esophagus and the possible benefit of the retrosternal reconstruction route, we retrospectively analyzed the records of patients who had resection of a malignant tumor of the esophagus, or the gastroesophageal junction, and a prevertebral reconstruction. The extra-anatomic route would have been only beneficial for patients with intrathoracic tumor recurrence distant from the anastomosis and causing gastrointestinal symptoms. Between 1983 and 1989, 209 patients (mean age of 61.3 years at the time of operation) had "curative" resection and prevertebral reconstruction in the institution of this study. Seventy-three patients (35 percent) had locoregional tumor recurrence. Univariate and multivariate analysis of various risk factors for locoregional recurrence showed that the presence of positive lymph nodes (pN1), especially if located at the celiac trunk (pM1), and a macroscopically non-radical R2 ...Continue Reading

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