Surgical Treatment of Esophageal Carcinoma in the Last 10 Years

Teruo Kakegawa

First Department of Surgery, Kurume University School of Medicine

Recent clinical and experimental studies on the surgical treatment of esophageal carcinoma, limiting lymph node dissection, are presented to clarify the present problems and future trends of this treatment. Between April 1980 and May 1989, we experienced 457 esophageal carcinomas, and 385 cancers, including 344 thoracic esophageal carcinomas were resected. We have obtained the following conceptions concerning lymph node dissection from these patients and experimental models. 1) We usually have to take a "safe surgical margin" to dissect regional lymph nodes curatively. 2) We should attempt "reasonable lymph node dissection according to anatomical characteristics and lymph flow" because en bloc dissection ranging from the cervical to the thoracoabdominal regions is impossible in thoracic esophageal carcinoma. 3) We have to perform "function preserving lymph node dissection" to maintain postoperative systemic functions. 4) We have an idea of "quality of life" in curative surgery for esophageal carcinoma considering the cancer's characteristics based on surgical oncology.

Key words
esophageal carcinoma, lymphnode dissection, bilateral neck dissection, postoperative respiratory function, surgical oncology

Reprint requests
Teruo Kakegawa The First Department of Surgery, Kurume University School of Medicine
67 Asahi-machi, Kurume, 830 JAPAN

Accepted
November 8, 1989

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