Siewert J R, Hölscher A H, Roder J, Bartels H
Chirurgische Klinik und Poliklinik, Technische Universität München.
Langenbecks Arch Chir. 1988;373(6):367-76. doi: 10.1007/BF01272555.
En-bloc esophagectomy not only comprises the elimination of the esophagus but also the mediastinal lymphadenectomy and the resection of the azygos vein and thoracic duct. Additionally the suprapancreatic abdominal lymphadenectomy is included and in tumors located orally of the tracheal bifurcation also the cervical lymphadenectomy. The surgical technique can be estimated as fully developed and standardized. Possible complications are postoperative hemorrhage (3.3%), chylothorax (1.6%) and tracheal lesions (4.9%). The mortality rate ranges under 10% in experienced centers, in our own patients around 6.6%. With en-bloc esophagectomy an exact staging of esophageal cancer becomes possible. In a high percentage complete tumor elimination (R0-resection) can be achieved and it seems that herewith prognosis in early tumor stages (T1/2N0/1) can be improved.
