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Ann Thorac Surg 1983;36:396-401
© 1983 The Society of Thoracic Surgeons

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Articles

Retrosternal Gastric Bypass for Inoperable Esophageal Cancer: A Report of 71 Patients

University of the Witwatersrand and the Johannesburg Teaching Hospitals, Johannesburg, South Africa

Accepted for publication August 31, 1982.

^* Address reprint requests to Dr. Conlan, Department of Cardio-Thoracic Surgery, University of the Witwatersrand Medical School, Esselen St, Johannesburg 2001, South Africa

Palliative substernal gastric bypass was performed in 71 patients with unresectable cancer of the intrathoracic esophagus. Fifty-six patients (78.9%) left the hospital, 53 eating normally and 3 on a soft diet. There were 15 hospital deaths (21%), 8 due to respiratory failure and pulmonary sepsis with tracheoesophageal fistulization. The remaining 7 deaths were due to aspiration and respiratory failure in 2 patients, anastomotic leakage with sepsis in 2, subphrenic abscess and septicemia in 1, mediastinitis in 1, and intestinal obstruction in 1. Anastomotic leakage occurred in 17 patients (23.9%), 5 of whom died. Wound infections developed in 28 patients (39.4%), 3 with mediastinal esophagocutaneous fistulas. Reestablishment of unimpeded swallowing, relief of respiratory aspiration, isolation of cancerous tracheobronchial infiltration, and freedom from incident-prone endoesophageal tubes were achieved in all patients leaving the hospital. Information is presented on 25 patients who were available for follow-up.

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