Extented esophago-gastretomy as surgical treatment for carcinoma of the cardia

Abstract

With the object of designing a feasible and more radical surgical intervention for the treatment of carcinoma of the gastric cardia and improving the long term survival of these patients, a procedure was described which entails total esophagogastrectomy and resection of the distal pancreas, spleen and regional lymphnodes. The esophagus was mobilized via the diaphragmatic hiatus without thoracotomy. Intestinal continuity, installed isoperistaltically was restituted in the same operation using a segment of transverse and descending colon transferred to the left lateral cervical aspect by way of the posterior mediastinum. The procedure was used in four patients and mortality and serious complications were nil.

Total esophagogastrectomy in the neoplasms of the esophagus and esofagogastric junction: when must be indicated?

“…Moreno-Gonzalez et al 16 in Spain, reported three cases of total esophagogastrectomy in advanced tumors of esophagogastric junction. Abularach C et al 18 in Chile, reported the same surgery in five cases of tumors of esophagogastric junction, patients with a mean age of 50 years, mean hospital stay of 20 days, without mortality.…”

“…The mainly indication for such a complex operation are restricted and tumors of esophagogastric junction, and the minority that affect large portions of the esophagus and stomach, extrapolating Siewert classification (14). The advanced nature of these tumors at the time of diagnosis, justifies the prognosis of patients 10,[14][15][16][17] . This characteristic is clear in this series of cases, of which 80% belonging to stages III and IV.…”