Surgical treatment of esophageal carcinoma.

Recent progress in the surgical treatment of carcinoma of the esophagus has changed the pessimistic outlook for this malignancy. With reasonably early diagnosis, it is feasible to achieve a resectability rate of 75 to 85 percent, an operative mortality of about 5 percent and a 5 year survival rate of about 30 percent. With careful selection of patients for operation and proper use of radiation and other adjunctive therapy, even more encouraging results are possible. Efforts for further improvement may be directed toward early diagnosis, refinement in operative technique and better pre- and postoperative care. The use of microsurgery and the development of mechanical suture apparatus in esophageal reconstruction after resection may further improve surgical treatment of cancer of the esophagus. Thoracic surgeons still have the responsibility to improve the management of the nonresectable cases of carcinoma of the esophagus.