Gastro-esophageal isoperistaltic bypass in the palliation of irresectable thoracic esophageal cancer

Int Surg. 1997 Jul-Sep;82(3):249-53.

Abstract

Methods: The authors retrospectively review 22 patients with irresectable esophageal cancer in whom an isoperistaltic substernal gastric esophagogastric bypass was performed.

Results: After the operation eighteen patients (82%) regained normal swallowing. Seven patients developed anastomotic stenosis that was successfully treated in six by surgery or endoscopic dilatation. Two patients evolved with cervical fistulae until their death. As a whole, there was a statistically significant improvement in swallowing capability (p = 0.0352). Seventeen patients (77%) had postoperative complications, the most common being cervical fistulae (in 13.59%), pneumonia (in 10.45%) and anastomotic stenosis (in 7.32%). Postoperative morbidity was significantly associated with preoperative diseases and ASA class III (p < 0.05). There were three postoperative deaths (14%). Postoperative mortality was significantly related to severe malnutrition and preoperative associated disease (p < 0.05).

Conclusions: The conclusion is that the procedure has acceptable morbidity and mortality for the population under consideration, permitting palliation of dysphagia in the majority of cases.

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Squamous Cell / complications
  • Carcinoma, Squamous Cell / surgery*
  • Deglutition Disorders / etiology
  • Deglutition Disorders / surgery
  • Esophageal Neoplasms / complications
  • Esophageal Neoplasms / surgery*
  • Esophagus / surgery*
  • Female
  • Humans
  • Male
  • Methods
  • Middle Aged
  • Palliative Care*
  • Postoperative Complications
  • Retrospective Studies
  • Stomach / surgery*
  • Treatment Outcome