J.Jpn. Surg. Soc.. 87(9): 1036-1039, 1986

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Report on the annual meeting

SELECTION AND INDICATION OF CERVICAL ESOPHAGECTOMY AND LYMPHADENECTOMY FOR CARCINOMA OF THE CERVICAL ESOPHAGUS

I) Fifty-five (75.3 percent) out of 73 cases of cervical and hypopharyngeal cancers were resected. The standard operative procedure for reconstruction after resectin was interposition of pedicled jejunal segments between the cervical esophagus or the hypopharynx and the upper thoracic esophagus with or without total laryngectomy. The five-year survival rate of 11 patients undergoing the operation preserving the larynx was 27.3 percent and that of 20 patients undergoing the operation with laryngectomy was 18.0 percent.
II) A successful case of reconstruction with a free jejunal segment between the hypopharynx and the middle thoracic esophagus under the right thoracotomy for carcinoma involving both the cervical and thoracic esophagus is introduced.
III) In cases of tumors localized in the cervical esophagus and/or hypopharynx, lymphnode dissection for cervical nodes was done bilaterally in the neck, and for paraesophageal and paratracheal nodes in the upper thorax, such dissection was performed from the cervix as much as possible without thoracotomy. In case of tumors involving both the cervical and the thoracic esophagus, lymphadenectomy was performed in the neck and also in the thorax with thoracotomy, and total esophagectomy was done.
IV) Postoperative combined therapies such as radiotherapy covering the whole cervix and the mediastinum accompanied by chemotherapy are indispensable for the prevention of recurrence.

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