[Indications for retrosternal esophagocoloplasty].

The authors define, based on experience with 55 retrosternal oesophagocoloplasties, the indications for this operation. They divide the indications into three groups and describe them as 1. the most suitable operation, 2. as the only possible replacement of the oesophagus, 3. as a palliative operation in an otherwise insolvable disphagia due to an inoperable tumour. They emphasize the wide range of indications for the operation which can be implemented without influencing the basic disease of the oesophagus and which makes it possible to apply combined treatment. The operation, though pretentious and time consuming, has the advantage of an extrathoracic approach. As to technical aspects, the authors emphasize the importance to select a portion of the gut with an adequate blood supply. This demand is usually met by the transverse colon on a vascular pedicle of the vasa colica sin.; they also mention the conditions of safe deposition of the gut in the retrosternal tunnel. The paper is supplemented by several case-histories of particularly interesting and difficult situations. If the indication range of the operation and its technical principles are respected and the surgeon is experienced, the failures of the operation are proportional to the severity of the basic disease.