[Surgical treatment of esophageal carcinoma complicated with perforation--a report of nine cases].

Malignant perforation in patients with esophageal carcinoma, a catastrophic life-threatening complication, is usually treated conservatively with very poor prognosis. From December 1992 through November 1994, surgical resections was carried out in 9 patients with perforated esophageal carcinoma of these 9 cases, two received esophagogastrectomy alone and 7 received esophagogastrectomy with synchronous pulmonary resections of various types. One patient died of anostomotic leakage on the 33rd postoperative day. Eight patients recovered uneventfully. Postoperative irradiation therapy was given to two patients: one in the third month due to mediastinal lymph node metastasis and the other is still being irradiated in the first month after operation. On follow-up, six patients had been surviving for 20, 18, 11, 9.5, 8.5 and 8 months after operation, respectively. In this paper options of treatment, pre-operative diagnostic procedures, intra-operative judgement and post-operative management for the perforated esophageal carcinoma are emphasized. The authors stress that the indication of extended operation for the esophageal carcinoma complicated with perforation should be further explored.