Abstract
In 1973, we successfully performed to extract the esophagus by inverting the structure without thoracotomy for a 71-year-old patient who had an advanced cervico-upper thoracic esophageal cancer. We named this procedure “esophageal stripping”. Since then, 68 cases of esophageal cancer and 2 cases of benign Barrett esophagus underwent this procedure. Elderly patients above 70 years old were 37 cases (52.9%) and the entire operative mortality rate was 11.7%. The lesion of esophageal cancer was cervical (Ce) in 3 cases, cervico upper thoracic (Ce+Iu) in 3, upper thoracic (Iu) in 3, middle thoracic (Im) in 20, middle thoracic and lower thoracic (Im+Ei) in 10, lower thoracic (Ei) in 13, abdominal and cardia (Ea+C) in 14, and another lesion in two, respectively. Reconstructive organ after esophagectomy was stomach in 62 cases, small intestine and colon in 7, and in one case reconstruction was not performed primarily. The operation time was within four hours in 40 cases and it was markedly shorter than that of standard method with thoracotomy. Postoperative prognosis (5-year survival rate) was 30% in esophageal stripping group and 10% in standard thoracotomy group. Intraoperative bleeding and postoperative complications decreased significantly and operative indications have been extended recently. This esophageal stripping is now technically feasible for thoracic esophageal cancer and the operative technique is shown herein.
