Surgical Treatment and Results of Cervical Esophageal Carcinoma

A retrospective review of cases of cervical esophageal carcinoma treated at our surgical department from 1970 to 1985 was performed. Fourty of 283 cases with squamous cell carcinoma of the esophagus had primary tumors in the cervical esophagus including the cervicothoracic reagion. Visceral replacements were employed in 25 patients by the isoperistaltic left pedunculated colon in 21, the antiperistaltic left colon in one, the isoperistaltic right colon in 2, the stomach tube in one, the free jejunal transfer in one and the skin flap in one case. The operative mortality rate was 13.8%. The 5-year cumulative survival rate of the patients, who had underdone curative resection calculated by the actuarial method was 32.6%. Pedunculated colonic tube has been used for substitution, adequate length can be obtained and the blood supply is relatively good. The anastomotic leakage in the neck, including minor leakage, was the most frequent nonfatal complication and had been estimated to occur in as many as 40% of the patients. Although transit is mainly by gravity, long term function has been excellent, which makes the isoperistaltic left colonic interposition most suitable for patients who have a long life expectancy.