[Surgery for carcinoma of the oesophagus. A plea for precise technique and pleuro-mediastinal drainage (author's transl)].
During surgery for carcinoma of the oesophagus, the authors emphasise the need for selective intubation using a Carlens tube, of avoiding damage to the diaphragm and the phrenic nerve at all levels, and of draining the hemithorax involved in the operation by three drains: anterior and posterior thoracic and madiastino-abdominal. These precautions reduce post-operative difficulties, justifiy excision surgery for carcinoma of the oesophagus, and to a certain extent make it possible to reduce the contraindications, in particular in the presence of tracheo-bronchial spread. Amongst 107 patients undergoing surgery, in whom there was a risk of respiratory insufficiency in one quarter, surgery (sometimes with extension of the excision: one case in four) was associated with an operative and post-operative mortality of 18%.