Presternal gastric bypass for unresectable carcinoma of the thoracic oesophagus: a preliminary report.

Presternal gastric bypass was performed on 10 African patients with unresectable carcinoma of the thoracic oesophagus. Where the cancer involved the lower third of the thoracic oesophagus the oesophagus was simply excluded. However, for cancer of the upper and middle third of the thoracic oesophagus the additional step of Roux-en-Y jejunal anastomosis to the intra-abdominal oesophagus was performed to drain away oesophageal secretions from existing or imminent tracheo-oesophageal fistulas. No patient died as a result of the operation, and 9 out of 10 patients were able to eat normally afterwards. Presternal gastric bypass is compared with other methods of palliation for unresectable carcinoma of the thoracic oesophagus.