[Differential diagnosis of cancer recurrence and cicatrical stricture of esophageal anastomosis].

A careful analysis was made of the causes, terms of occurrence and course of cancer recurrence in the area of gastrointestinal and gastroesophageal anastomoses after 498 gastrectomies, resections of the cardia and esophagus for cancer. The possibility of the differential diagnosis between the recurrence and cicatricial strictures of esophageal anastomoses is shown. Based on the clinico-roentgenological data etiopathogenetically 3 variants of cicatricial strictures were singled out: a) due to technical errors, inadequate anastomotic sutures and fistulas; b) due to grave anastomositis, and c) due to reflux-esophagitis. Among cancer recurrences at the site of esophageal anastomosis three forms were differentiated, depending on the origin of recurrence and a form of tumor growth: exophitic, endophitic and paraesophageal recurrence. Special attention is given to an early recurrence and the development of it against the background of pre-existing cicatricial stricture of the anastomosis.