Surgical strategies for esophageal cancer | Chirurgische therapiestrategien beim ösophaguskarzinom

Thurau, K.,Palmes, D.,Brüwer, M.,Senninger, N.

Abstract

Surgical treatment of esophageal carcinoma remains crucial for the prognosis even within multimodal treatment procedures. Important goals of preoperative staging consist therefore not only of the identification of curative surgery but also of prediction of the perioperative risk. In the case of curative treatment surgical success highly correlates with the extent of lymphadenectomy. In western countries a two-field lymphadenectomy by right-sided transthoracic and transabdominal access is regarded as the standard. Gastric tube formation with intrathoracic anastomosis represents the preferred approach for reconstruction. A standardized perioperative management is crucial for reduction of postoperative complications. The corresponding individual caseload of the surgeon and the centre experience, including preoperative risk analysis, tumor board and regular interdisciplinary conferences are crucial to reduce perioperative mortality to below 5%. © 2010 Springer-Verlag.