[The surgical treatment of cancer of the esophagus and cardia. The complications and hazards]. / Khirurgicheskoe lechenie raka pishchevoda i kardii. Oslozhneniia i opasnosti.

One-stage operations for carcinoma of the esophagus and cardia were performed on 100 patients. The substitution of the resected esophagus was made with a isoperistaltic tube from the greater curvature of the stomach with anastomosis on the neck, in the pleural or abdominal cavities. Palliative interventions were fulfilled on 31 patients with inoperable carcinomas. An analysis of the structure and causes of postoperative complications and postoperative lethality has shown that among the most frequent causes of deaths in the postoperative period were purulent-infectious complications as a result of ischemia of gastric transplants and incompetence of sutures of the anastomoses as well as pleuro-pulmonary complications. Special attention was given to an analysis of complications after operations performed without thoracotomy from the cervico-abdominal access. The amount of postoperative complications was 30%, postoperative lethality 15%. One-year survival after operations made up 57%, 3-year survival--less than 30%, 5-year survival--less than 15%. Some recommendations are given for the surgical policy and methods of prophylactics of certain complications. Endolymphatic infusions of cytostatics used as adjuvant chemotherapy in complex treatment of patients with cardioesophageal carcinoma represent a perspective direction providing longer life of the patients without recidivations. From the oncological viewpoint the operation without thoracotomy are not always thought to be justifiable.

[The morphofunctional status of the isoperistaltic gastric transplant for esophagoplasty]. / Morfofunktsional'noe sostoianie izoperistal'ticheskogo zheludochnogo transplantata dlia plastiki pishchevoda.

Thirteen patients with carcinomas of the esophagus underwent one-stage operations--extirpation of the esophagus without thoracotomy with simultaneous esophagoplasty using isoperistaltic gastric tube made of the greater curvature of the stomach, in posterior mediastinum with esophagogastrostomy in the neck. The morphofunctional state of the gastric transplants was investigated at early and late periods (for 8 months) after operations. The reduction of blood in the transplants to 40% of the initial, deterioration of acid production, depression of the motility, ischemic atrophy of mucosa and increased fibrosis in submucosa were revealed. Nevertheless satisfactory results of the isoperistaltic tubular esophagoplasty were obtained in 77% of patients in early periods and in 54% of the patients during the first year after operation.