J.Jpn. Surg. Soc.. 91(9): 1112-1116, 1990

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Report on the annual meeting

SURGICAL TREATMENT FOR THORACIC ESOPHAGEAL CARCINOMA

In Japan, esophageal surgery was started in 1932 by Professor Seo and Ohsawa. And then, recent surgery for thoracic esophageal carcinoma has been performed safely because of improvements of perioperative care and surgical technique. However, there are many problems unsolved about the curative operation at the present time. They are "How shall we do curative lymph node dissection?, "How shall we prevent postoperative complications?", "What is the most profitable visceral organs for esophageal reconstruction?", and "How to employ pre- and post-operative combined therapy?". We resected 344 carcinomas situated in the thoracic esophagus between April 1980 and March 1990. I would like to present our measures for these surgical problems based on our clinical and experimental studies. ① We have to take "safe surgical margin" to curatively dissect regional lymph node. ② We should attempt "reasonable lymph node dissection" according to anatomical characteristics and esophageal lymph flow. ③ We have to perform "function preserving lymph node dissection" to maintain postopertive cardiorespiratory function. ④ We allways have an idea of "quality of life of the patient and profitable surgery" in radical esophagectomy considering biological characteristics of each individual cancer based on surgical oncology.

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