Long‐term evaluation of patients treated by radical operation for carcinoma of the thoracic esophagus

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Abstract
During the past 19 years, resection has been performed on 457 (72.9%) of 627 patients with carcinoma of the thoracic esophagus; curative resection was done in 388 patients. Among the 259 (57%) patients who underwent reconstruction through the retromediastinal space, thoracic esophagogastrostomy accounted for 181 and interposition of jejunal segments between the thoracic esophagus and the stomach accounted for 78 patients. Among the 171 (37.4%) patients who underwent reconstruction through the retrosternal space, there were 110 with esophagogastrostomy, 57 with interposition of jejunal segments, and 4 with colonic segments between the esophagus and the stomach. Comparing the reconstructive organs or the reconstructive routes used, there were no significant differences in the incidences of pulmonary complication, leakage, or operative death.Among the patients who tolerated curative surgery, the 5‐year and 10‐year survival rates were 31% and 23.1%, respectively. Comparing operative procedures, there were no significant differences in survival rates. Reconstruction was also performed in postgastrectomized patients using jejunal segments.There was a considerable number of complaints of passage failure and reflux esophagitis such as heartburn among patients who underwent esophagogastrostomy performed in the thoracic cavity, even 5 years after surgery.The performance status of patients in whom jejunal segments were used was better than that of patients in whom gastric tubes were used.