Esophageal cancer: Thoracotomy versus non-thoracotomy
83 patients with advanced symptomatic cancer of the esophagus and cardia were managed surgically with an overall resectability of 78.4%. 2 general approaches were used on a comparative basis, the conventional transthoracic (41 patients) and the more recently advocated non-thoracotomy operations (24 patients). Opening the chest seems mandatory for upper third esophageal tumors but contributed more to an overall mortality of 16.2%, without assuring a higher cure or longer survival rate. Not opening the chest lowered post-operative complications but led to cervical anastomotic fistulae in 20% of cases. Long-term survival was poor, reconfirming the role of the pathological stage of tumor in determining long-term results, and the need for detection for early cases, particularly in high incidence areas.