Reconstruction of oesophagus for oesophageal carcinoma.

This paper presents a prospective study of early and late results in 92 patients (64 men and 28 women, aver age 51.5 years), with reconstruction of oesophagus performed for oesophageal carcinoma after partial or total esophagectomy with logoregional lymphadenectomy. Ninety-two selected patients divided into five groups (belong to pTNM stage 0, I, IIa, IIb and partly III) were subjected to this investigations. The investigated five groups included two groups of patients with esophageal carcinoma who have had esophagetcomy, left colon reconstruction with gastric and oesophageal anastomosis 21 cases and 28 patients with esophagectomy, cervical colostomy and oesophagostomy (first-stage) and skin tube in the neck (second-stage). In the remain investigated three groups, after eosophagectomy, a gastric transposition (in retrosternal position). Chung's pyloromyotomy and oesophagogastrostomy (first-stage) and the skin tube in the neck (second-stage), were carried out in 18 patients. Gastric transposition in the right pleural cavity, Chung's pyloromyotomy and oesophagogastrostomy were performed in 12 patients. The incidence of leak in the group who have had oesophagocolostomy was in four patients and later on, the stenosis in three cases, while in oesophagogastrostomy group (in retrosternal position) leak occurred in three patients, but later on, there was no stenosis. In the oesophagogastrostomy group in the right pleural cavity, leaking occurred in two patients, without late stenosis. There was only one leak in both two-stage operated groups and no late stenosis. The results of this study indicated that the two-stage oesophageal operation gives the most satisfactory reconstruction of oesophagus.