[The surgical treatment of carcinomas of the opening of the oesophagus. Personal experience. Selection of a technique of oesophagoplasty (author's transl)].

The authors describe the principles relating to the excision of carcinomas involving the opening of the oesophagus. They emphasize the need for low section of the oesophagus, or even total oesophagectomy by virtue of the frequent submucosal spread of the tumour process. The need for resection of this type eliminates the possibility of repair by the Bakamgian flap type and involve the need for a long intestinal segment with a difficult digestive anastomosis in the middle of the thorax if a free intestinal transplant is selected. The authors themselves carry out oesophagoplasty using the transverse colon which in common with the majority of other authors, they feel to be the technique of choice. However, on the basis of their brief experience, they wish above all to discuss the criteria of operability, rarely discussed elsewhere, and concerning spread to the membranous trachea and the possibility of perivisceral tumour spread which cannot be detected by classical techniques. They suggest the use of a prior mediatinoscopy incision in order to attempt to assess any such possible spread.