SUBSTERNAL GASTRIC BYPASS OF THE EXCLUDED ESOPHAGUS - RESULTS OF AN ILL-ADVISED OPERATION

  • 1 January 1984
    • journal article
    • research article
    • Vol. 96  (3) , 467-470
Abstract
Substernal gastric bypass of the excluded thoracic esophagus for palliation of esophageal carcinoma was proposed as a method of providing maximum patient comfort with minimum morbidity. Results with this operation in 37 patients are reviewed and they indicate that the procedure carries unacceptable complication and mortality rates. Among the patients, there were 9 (24%) hospital deaths, 7 (19%) anastomotic leaks and 6 (17%) disruptions of the divided distal thoracic esophagus. Major postoperative complications occurred in 59% of these patients. Only 15 (54%) of the 28 survivors were discharged swallowing within 3 wk of operation, and 10 (36%) required hospitalization for 1 mo. or longer after operation. The average survival time in those leaving the hospital alive was only 5.9 mo. Only 7 patients (25% of the survivors) achieved good palliation with the bypass procedure. Substernal gastric bypass of the excluded thoracic esophagus is too much of an operation for patients with unresectable tumors who have a life expectancy of only several months.

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