J.Jpn. Surg. Soc.. 91(9): 1215-1218, 1990
Report on the annual meeting
RADICAL OPERATION FOR CARCINOMA OF THE ESOPHAGO-GASTRIC JUNCTION
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Department of Surgery, Niigata University School of Medicine, Niigata, Japan Otsuo Tanaka, Terukazu Muto, Tsutomu Suzuki, Kikuo Aizawa, Norio Katayanagi |
Our standard surgical approach in surgery for EGJ-Ca is laparotomy combined with median sternotomy. Right thoracotomy is added in patients with carcinoma extending to the thoracic esophagus.
One hundred and sixty patients underwent lower esophago-gastrectomy for EGJ-Ca in our institute without right thoracotomy was performed in 40 cases, laparotomy with left thoracophrenotomy in 53, laparotomy alone in 49, and others in 18. One hundred and ten patients (68.8%) underwent lower esophagectomy with total gastrectomy. Caudal hemipancreatectomy with either total or proximal gastrectomy was carried out in 141 patients (88.1%).
Lymph node metastases ware seen in 117 patients (73.1%). Lower mediastinal lymph nodes were involved in 17 patients (10.6%). The 5-year survival rates in patients undergoind curative surgery were 61.9% in those with sternotomy, 40.0% with left thoracophrenotomy, and 28.2% with laparotomy alone, respectively.
These results show that laparotomy with median sternotomy may be a preferable surgical approach in radical surgery for EGJ-Ca. In addition, right thoracotomy whould be required if indicated.
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