Diagnostic and therapeutic thoracoscopy in esophageal cancer.

The decision before operation whether an esophagus affected by cancer can be resected is difficult. In order to determine if the tumor can be removed or not, patients must undergo surgery. This high risk intervention is often carried out only to prescribe palliative treatment. We used a thoracoscopic technique for the diagnosis and resection of esophageal cancer with the aim of improving the high morbidity rate associated with esophageal open surgery. A right thoracoscopy was performed in seven patients and only four underwent resection. The entire esophagus was mobilized thoracoscopically and the intervention was completed through the abdomen and the neck. In three patients in whom resection was not considered possible, the thoracoscopic procedure was done with excellent tolerance, and treated by palliative methods. Thoracoscopy is a very valuable procedure for the diagnosis of resectability as well as for the mobilization of the esophagus prior to resection.