[Operative procedures of T1 cancer of the lower thoracic esophagus].

Pathological results for 70 cases of T1 EiEa esophageal cancer resected in our department for the past 12 years, have shown 32 cases of mucosal cancer and 38 cases of submucosal cancer. Lymph node metastasis was recognized in 21 cases (30%). Moreover, positive nodes were observed only in submucosal cancer cases. Lymph node metastasis was mainly observed in the lower mediastinum and in the upper abdomen. However, it was frequently observed in the upper mediastinum (106) and sometimes in the supraclavicular area (104). The lymph node dissection should be performed in the mediastinum through the upper abdomen and neck. The subtotal esophagectomy with thoracotomy and the systematic dissection is common operative procedures, but the reduced surgery, i.e. transhiatal esophagectomy or the lower esophagectomy and proximal gastrectomy, is also indicated in some cancer patients.