Modern approaches to surgical treatment for cardio-esophageal cancer

The experience of surgery in 224 patients with cardio-esophageal cancer treated in the Kazan Republic Clinical Oncology Dispensary is presented. The patients are divided into 3 groups in respect of the type of adenocarcinoma (classification by J.R. Siewert). Thus, the first group consists of 35 (15.6 %) patients, the second-107 (47.8 %) and the third - 82 (36.6 %) patients. Each group is divided into subgroups according to the performed operation: transhiatal esophagoplasty with esophagogastroanastomosis on the neck, transthoracal esophagoplasty (operations by Lewis and Gerlock) with intrapleural esophadogastroanastomosis and gastrectomies with high resection of esophagus. High productivity of the differentiated approach to surgical treatment of cardio-esophageal cancer depending on the type of adenocarcinoma is shown. So, it is revealed that performance of transhiatal and transthoracal esophagoplasty is possible in cases of type I adenocarcinoma. Gastrectomies in cases of type II adenocarcimoma are of poor prognosis. And type III adenocarcinoma makes transhiatal esophagoplasty extremely unfavorable.