Comparative aspects of lymph-dissection in surgical treatment of cardio-esophageal cancer

The comparative analysis of short-and long-term treatment results for patients with cardio-esophageal cancer (CEC) treated during the1990-2004 period was carried out. The control group included 213 patients who had been operated in the early period with lymph-dissection D0-D1. The studied group consisted of 164 patients who underwent radical surgeries according to Lewis, Osava-Garlock and Savinykh with abdomen-mediastinal lymph-dissection. There were 75 gastroectomies (with extirpation of gastric remnant), 46 Lewis's operations and 43 subtotal proximal stomach resections. Over the last 5 years, the differential approach to selection of access and extent of resection or to gastric and esophageal extirpations has allowed the lethality and recurrence rates to be decreased. Surgery with combined accesses according to Lewis and Garlock provides reliable anastomosis and abdomen-mediastinal lymph-dissection. The 5-year survival rate in the studied group is 20 % higher than that in the control group.