[Value of computer tomography for evaluation of local operability and choice of surgical procedure in esophageal cancer].

The correlation of the preoperative staging by CT with the post-operative or postmortem staging was investigated in 74 patients with esophageal carcinoma. Criteria for the evaluation of local resectability were analyzed prospectively. According to TNM-classification, the pre- and post-operative staging showed identical results in T1 in 3/4, in T2 in 17/26 and in T3 in 42/44 patients. Thus, the preoperative staging turned out to be correct in 62/74 cases (83.7%). By conventional diagnostic methods identical results of pre- and postoperative staging were found in 28/74 patients (37.8%). The local resectability can be judged by the sagittal infiltration area and especially by the vertical extent of tumor infiltration of the aorta and/or trachea. Esophageal resection was not possible, if infiltration had been suspected in more than 4 tomograms (8 mm-CT-sections). Only palliative resection could be performed in cases with a 3 tomogram infiltration. A suspected infiltration up to 2 tomograms did not exclude a blind dissection of the esophagus without thoracotomy. The impression of the trachea with an irregular borderline of the lumen or tumor growth surrounding the trachea are additional infiltration signs in the CT. By the differentiated interpretation of local tumor growth the CT reached a central position planning surgical strategy.