J.Jpn. Surg. Soc.. 79(9): 1232-1236, 1978

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Report on the annual meeting

THE LEFT THORACO-ABDOMINAL APPROACH FOR CARCINOMA OF THE ESOPHAGOGASTRIC JUNCTION

In a total of 216 cases with carcinoma of the cardia, resection and reconstruction were carried out in 156 cases during the period between October 1972 and December 1977. Thus, the resectability rate was 72.2%. The left thoraco-abdominal approach and the abdominal approach were adopted in 84 and 72 cases respectively. One death occurred on the 7th postoperative day due to acute hepatic failure among the 84 cases treated by the left thoraco-abdominal approach (1.2 %), and one on the 41 st postoperative day due to pulmonary embolism among the 72 cases treated by the abdominal approach (1.4%). The total operative mortality for resection and reconstruction of carcinoma of the cardia was 1.3%.
For surgical treatment of carcinoma of the esophagogastric junction or those which are close to the junction, the left thoraco-abdominal approach has the following advantages. 1) The approach provides excellent exposure of the region. 2) It is possible to cope with any degree of extention of the tumor by this approach. 3) There is no necessity to change the position of the patient during the operation. 4) Various types of reconstructive procedures or bypass procedures may be done by this approach. 5) The operation can be carried out with little surgical risks. Operative mortality is low. Postoperative recovery is usually uneventful.

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