Surgery for Advanced Esophageal Cancer

Tetsuro Nishihira

Second Department of Surgery, Tohoku University School of Medicine

In cases of advanced esophageal cancer, it is necessary for the surgeon to have a thorough knowledge of the anatomical characteristics of the esophagus and of the complicated and diverse lymph flow unique to the mediastinum. Surgeons must be well trained, knowledgeable and experienced in order to treat this kind of cancer. Even when the tumor is small, multiple lymph node and organ metastases are sometimes detected. In this paper, we report our experience and that of three other institutions in Japan in surgically treating several cases of advanced esophageal cancer, with invasion of the aorta, trachea, and/or bronchi, in which surgery would not usually be attempted due to the high risk involved and the delicate operative techniques required. Moreover, site dependent tendencies of esophageal lymph node metastasis. Furthere more for recurrent tumors, maintenance of phonation, combined adjuvant therapies, and mechanisms of the resistance against chemotherapy and/or radiation are discussed.

Key words
combined resection of the thoracic aorta, combined resection of the trachea and bronchus, esophageal cancer

Reprint requests
Tetsuro Nishihira Second Department of Surgery, Tohoku University School of Medicine
1-1 Seiryou-chou, Aoba-ku, Sendai, 980-77 JAPAN

Accepted
May 21, 1997

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