The Journal of Thoracic and Cardiovascular Surgery, Vol 70, 817-825, Copyright © 1975 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Esophagogastrostomy. Analysis of 55 cases
AD Boyd, R Cukingnan, RM Engelman, SA Localio, L Slattery, DA Tice, JA Bardin and FC Spencer
At the New York University Medical Center from January, 1969, through
December, 1973, esophagogastrostomies were performed in 56 patients. In 30
(Group A), fundoplications were combined with the esophagogastrostomies; in
the other 26 (Group B), esophagogastrostomies only were performed. These
two groups have been compared in an effort to determine the effectiveness
of fundoplication in preventing gastric reflux following
esophagogastrostomy. The operative mortality rate (10 per cent) and the 3
year survival rate (20 per cent) were approximately equal in the two
groups. Clinical evidence of reflux was noted in 10 per cent of Group A and
47 per cent of Group B patients, while complications of reflux were noted
in 5 per cent of Group A and in 33 per cent of Group B patients. The
results of the present study suggest that fundoplication, while not
prolonging survival, does prevent the symptoms and complications of gastric
reflux and improves the quality of survival in these unfortunate patients.
This leads us to recommend the routine use of fundoplication with
esophagogastrostomy in patients with carcinoma of the esophagus and gastric
cardia.