Extensive lymph node dissection for thoracic esophageal carcinoma

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Abstract
The outcomes of extensive lymph node dissection for thoracic esophageal carcinoma are described. Such dissection is presently applied in patients whose condition satisfies strict criteria. Lymph nodes of the middle and lower third of the mediastinum, including those in the upper abdomen are dissected as in conventional dissection, together with left and right paratracheal, tracheobronchial and inferior aortic nodes in the upper mediastinum. Fifteen cases subjected to extensive dissection and 99 cases subjected to conventional dissection were compared and examined over a four-year period. No direct surgical deaths were noted. Patients subjected to extensive dissection tended to show markedly slow recovery of the cough reflex and required tracheotomy. There was no difference between the two groups in the occurrence of cardiovascular and/or pulmonary complications at the time of discharge, nor in the postoperative quality of life. This retrospective evaluation supports the routine application of extensive dissection.

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