Two-stage operation for poor-risk patients with carcinoma of the esophagus.

We have devised a two-stage operation for poor-risk patients with carcinoma of the thoracic esophagus. The first-stage operation consists of a right thoracotomy, subtotal esophagectomy, and lymph node dissection. Two to three weeks later, the second-stage operation of esophageal reconstruction with gastric tube is performed under laparotomy. During this 3-week period of no esophagus, the nutritional status can be adequately maintained by intravenous hyperalimentation. We describe herein the technique, postoperative complications, and mortality of our two-stage operation as compared with events during an ordinary one-stage operation for carcinoma of the thoracic esophagus.