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Resumen Introduccion La reconstruccion esofagica es un proceso quirurgico tecnicamente muy complejo, gravado por una importante morbilidad. Clasicamente se han utilizado la gastroplastia y la coloplastia, aunque la yeyunoplastia ya fue descrita por Roux en 1907. Parece demostrado que la plastia de yeyuno libre es una muy buena opcion en el tratamiento de la enfermedad del esofago cervical, pero no esta tan claro el papel de la yeyunoplastia supercharged en la reconstruccion del esofago toracico. El objetivo de este estudio es el analisis de las reconstrucciones esofagicas realizadas en nuestra unidad y que precisaron de un injerto de yeyuno. Metodos Estudio retrospectivo de las reconstrucciones esofagicas realizadas con yeyunoplastias en nuestra unidad entre enero de 2011 y diciembre de 2019. Se analizan datos epidemiologicos, indicaciones, tecnica quirurgica y morbimortalidad. Resultados Se realizaron 67 procedimientos quirurgicos de reconstruccion esofagica compleja de los que 10 fueron yeyunoplastias: 5 yeyunos libres en esofago cervical y 5 supercharged en esofago toracico con abordaje transesternal. La morbilidad, mortalidad, estancia media y tiempo de retirada de la alimentacion enteral fueron menores en los yeyunos libres que en los supercharged. Conclusiones En nuestro grupo la yeyunoplastia supercharged es la ultima opcion para la reconstruccion del esofago toracico; el acceso por esternotomia media nos permite un excelente abordaje del mediastino anterior y los vasos mamarios internos. El yeyuno libre seria la primera eleccion —con indemnidad del resto de esofago— en la reconstruccion del esofago cervical.

Esophageal reconstruction is a very complex surgical procedure, burdened by significant morbidity. Gastroplasty and coloplasty have classically been used. Free jejunal plasty has shown to be a very good option in the treatment of cervical esophagus pathology, but the role of supercharged jejunoplasty in thoracic esophagus reconstruction is still controversial.A retrospective study of esophageal reconstructions with jejunoplasties performed in our unit between January 2011 and December 2019. Epidemiological data, indications, surgical technique, and morbidity and mortality were analyzed.67 procedures of esophageal reconstruction were performed, 10 of which were jejunoplasties: 5 free jejunums and 5 supercharged. Morbidity, mortality, mean stay and withdrawal time from enteral feeding were lower in free than in supercharged jejunums.Supercharged jejunoplasty was the last option for reconstruction of the thoracic esophagus. Median sternotomy access provides an excellent approach to the anterior mediastinum and the internal mammary vessels. The free jejunum would be the first choice, with the indemnity of the rest of the esophagus, in the reconstruction of the cervical esophagus.

Resumen Objetivo Describir la experiencia del abordaje robotico en la cirugia de la acalasia en un centro de tercer nivel. Material y metodos Se analizaron los pacientes con acalasia intervenidos mediante cirugia robotica entre mayo de 2010 y abril de 2019. Las variables a estudio se recogieron en una base de datos prospectiva y se realizo un analisis descriptivo. Resultados Se incluyeron 45 pacientes (55,6% varones) con edad media de 44 anos. El sintoma principal al diagnostico fue la disfagia. Diecinueve pacientes (42,2%) habian recibido tratamiento endoscopico previo a la cirugia, mayoritariamente dilatacion neumatica (84,2%). La tecnica quirurgica empleada fue la miotomia de Heller asociada a funduplicatura tipo Toupet, con un tiempo operatorio medio de 211 minutos. La estancia media fue 5 dias. Se produjeron 2 perforaciones postoperatorias (4,4%). La mortalidad peroperatoria fue del 0%. El seguimiento medio fue de 64 meses. A 3 y 5 anos se evidencio una importante disminucion del Eckardt score y el estudio manometrico mostro una disminucion de la presion del esfinter esofagico inferior en reposo media del 58% y del 70%, respectivamente, con persistencia de hipomotilidad del cuerpo esofagico. En dos pacientes (5,4%) se diagnostico reflujo gastroesofagico patologico y 4 (10,8%) presentaron recurrencia de los sintomas, requiriendo dilataciones neumaticas endoscopicas. En 2 casos las dilataciones no fueron efectivas por lo que se planteo la realizacion de una miotomia endoscopica. Conclusiones Segun nuestra experiencia, la cirugia robotica constituye un procedimiento seguro y efectivo para el tratamiento de la acalasia.

Introduction: Preoperative gastric ischemic conditioning (IC) improves the outcome of esophageal replacement gastroplasty and is associated with low morbidity. However, when the stomach cannot be used for esophageal replacement, a colonic replacement is required. The study aim was to assess the viability of right colon and terminal ileum IC in a rat model and the histological damage/recovery sequence and determine if neovascularization is a potential adaptive mechanism. Methods: The study was conducted in Rattus norvegicus with ileocolic vascular ligation. Seven groups of animals were established (6 rats per group) with groups defined by the date of their post-IC euthanasia (+1, +3, +6, +10, +15, and +21 days). Comparisons were made with a sham group. Viability of the model was defined as Results: Transmural colon necrosis occurred in 1/36 animals (2.78%) with no animal demonstrating transmural ileal necrosis. The maximum damage was observed in the colon on +1 day post-IC (average Chiu score 1.67, p = 0.015), whereas in the ileum, it was on days +1, +3, and +6 (average Chiu score 1.5, 1.3, and 1.17; p = 0.015, 0.002, and 0.015, respectively). In the +21-day group, histological recovery was complete in the colon in 4 (66.7%) of the 6 animals and in the ileum in 5 (83.3%) of 6 animals. There were no significant differences in quantitative neovascularization in any of the groups when compared with the sham group or when comparisons were made between groups. Conclusions: The tested animal model for IC of the colon and terminal ileum appeared to be feasible. Histological damage was maximal between the 1st and 3rd day following IC, but by day 21, recovery was complete in two-thirds of the rats. There was no evidence in this preliminary IC model that would suggest neovascularization as an adaptive mechanism.

The significance of molecular analysis of peritoneal fluid in staging laparoscopy of oesophagogastric junction (EGJ) and gastric cancer is still controversial. METHODS: A retrospective analysis of prospective data collection of all patients diagnosed with locally advanced gastric neoplasia or Siewert II-III EGJ cancer from July 2009 to October 2019 who underwent staging peritoneal lavage prior to neoadjuvant treatment was performed. Cytology studies and molecular analysis of peritoneal lavage were performed by real-time reverse transcriptase polymerase chain reaction (RT_PCR) of carcinoembryonic antigen (CEA) and cytokeratin 20 (CK20) as tumor makers. RESULTS: 168 patients were operated. Citology and molecular analysis were performed in 138 patients. Macroscopic carcinomatosis (P+) was evidenced in 12.3% (17 patients). Of the remaining 87.7% (121 patients), 9.9% (12 patients) had positive cytology. In 21% (29 patients) disseminated macroscopic or microscopic disease (P + or Cyt+) was identified. 11.6% (16 patients) were P0Cyt- but RT-PCR+. Of these, 9 responded to chemotherapy before salvage surgery. The sensitivity of cytology and molecular analysis was 0.70 and 0.76, respectively (p = 0.67). The survival of Cyt-RT_PCR + vs. Cyt + RT_PCR + patients was similar (p = 0.1). However, there were no differences in the survival curves between Cyt-RT_PCR- patients vs Cyt-RT_PCR + patients who underwent salvage surgery (p = 0.69). CONCLUSION: Molecular analysis showed a sensitivity of 76%. In our study, the survival of P0 Cyt-RT_PCR + patients responding to chemotherapy and undergoing surgery was similar to that of P0 Cyt-RT_PCR- patients but less disease free survival.

Resumen Introduccion El quilotorax es una complicacion poco frecuente en las esofagectomias pero que se asocia a un aumento de la mortalidad posquirurgica. Se han descrito diversos factores que pueden incrementar su aparicion y el tratamiento del mismo es controvertido, siendo la linfografia con embolizacion percutanea del conducto toracico uno de los usados por varios grupos. Material y metodo Estudio retrospectivo de los pacientes a los que se les realizo una esofagectomia por cancer de esofago o de la union esofagogastrica a Siewert I/II entre enero del 2010 y abril del 2019, y desarrollaron un quilotorax como complicacion. Se analizan datos epidemiologicos, el tipo de cirugia, la morbilidad y el tratamiento. Resultados Se realizaron 274 esofagectomias por cancer en el periodo comprendido. Trece pacientes (4,7%) fueron diagnosticados de quilotorax en el postoperatorio; 3 se resolvieron con tratamiento conservador. En los 10 pacientes restantes se realizo linfografia con puncion de la cisterna de Pecquet y embolizacion del conducto toracico, con resolucion del quilotorax en 9. Un paciente (10%) presento una fistula biliar despues del procedimiento. Conclusiones La linfografia con puncion de la cisterna de Pecquet y embolizacion del conducto toracico es una tecnica con baja morbilidad y buenos resultados en la resolucion del quilotorax postesofagectomia.

Introduction Chylothorax is a rare complication in esophagectomies that is associated with increased postoperative mortality. Several factors have been described that may favor its appearance. Its treatment is controversial, and lymphography with percutaneous embolization of the thoracic duct is used by several groups. Material and method Our retrospective study included patients who underwent esophagectomy for cancer of the esophagus or the esophagogastric junction (Siewert I/II) between January 2010 and April 2019 and developed chylothorax as a complication. Epidemiological data, type of surgery, morbidity and treatment were analyzed. Results 274 cancer-related esophagectomies were performed in the study period. Thirteen patients (4.7%) were diagnosed with chylothorax in the postoperative period; 3 were resolved with conservative treatment. In the remaining 10 patients, lymphography was performed with aspiration of the cisterna chyli and thoracic duct embolization, which resolved the chylothorax in 9. One patient (10%) presented a biliary fistula after the procedure. Conclusions Lymphography with aspiration of the cisterna chyli and thoracic duct embolization is a technique with low morbidity that provides good results for the resolution of chylothorax after esophagectomy.

Anastomotic leakage (AL) after Ivor Lewis esophagectomy is associated with high morbidity and mortality. Preoperative gastric conditioning (GC) improves blood perfusion of the gastroplasty, one of the most important factors for anastomotic viability. This pilot randomized controlled trial aimed to evaluate the feasibility of GC before oesophageal surgery in patients with oesophageal cancer or Siewert I-II esophagogastric junction cancer, who required an Ivor Lewis esophagectomy.This was a randomized (1:1), open-label, single-centre, controlled, parallel-group, pilot clinical trial. Two study groups: 1) GC-group: patients who underwent an Ivor Lewis esophagectomy and GC before surgery; 2) Surgery alone (SA)-group: patients who underwent only Ivor Lewis esophagectomy. Feasibility was assessed by means of the number of patients in whom a GC was performed, and the cumulative incidence of postoperative AL. Secondary endpoints were conduit necrosis (CN), hospital stay, morbidity, mortality, and anastomotic stricture.Between 2015 and 2018, 38 patients were randomized and analysed: 20 to GC-group and 18 to SA-group. 17 GCs (85%) were successfully performed, right gastric artery occlusion failed in three patients. Morbidity after GC occurred in 5/22 patients (all Clavien-Dindo ≤ IIIa). The cumulative incidence of AL was 15.0% (3/20, 95%CI: 5.2-36.0%) in GC-group and 33.3% (6/18, 95%CI: 16.3-56.3%) in SA-group, p-value: 0.184. CN: 0/20 vs. 1/18 (p-value: 0.474); surgical morbidity (Clavien-Dindo III-V): 7/20 vs. 12/18 (p-value: 0.070); hospital stay (median [range] days): 12 [9-45] vs. 27.5 [10-166] (p-value: 0.067). When only successful GCs (three arteries) were included for analysis, ischemia-related gastric conduit failure (AL and CN) was lower in the GC group (p-value: 0.041).Preoperative arteriographic GC before Ivor Lewis esophagectomy is a feasible and safe procedure and seems it may reduce AL in patients with oesophageal cancer or Siewert I-II esophagogastric junction cancer.

Background: The concept of textbook outcome (TO) has been proposed for analyzing quality of surgical care. This study assessed the incidence of TO among patients undergoing curative gastric cancer resection, predictors for TO achievement, and the association of TO with survival. Method: All patients with gastric and gastroesophageal junction cancers undergoing curative gastrectomy between January 2014–December 2017 were identified from a population-based database (Spanish EURECCA Registry). TO included: macroscopically complete resection at the time of operation, R0 resection, =15 lymph nodes removed and examined, no serious postoperative complications (Clavien-Dindo =II), no re-intervention, hospital stay =14 days, no 30-day readmissions and no 90-day mortality. Logistic regression was used to assess the adjusted achievement of TO. Cox survival regression was used to compare conditional adjusted survival across groups. Results: In total, 1293 patients were included, and TO was achieved in 541 patients (41.1%). Among the criteria, “macroscopically complete resection” had the highest compliance (96.5%) while “no serious complications” had the lowest compliance (63.7%). Age (OR 0.53 for the 65–74 years and OR 0.34 for the =75 years age group), Charlson comorbidity index =3 (OR 0.53, 95%CI 0.34–0.82), neoadjuvant chemoradiotherapy (OR 0.24, 95%CI 0.08–0.70), multivisceral resection (OR 0.55, 95%CI 0.33–0.91), and surgery performed in a community hospital (OR 0.65, CI95% 0.46–0.91) were independently associated with not achieving TO. TO was independently associated with conditional survival (HR 0.67, 95%CI 0.55–0.83). Conclusion: TO was achieved in 41.1% of patients who underwent gastric cancer resection with curative intent and was associated with longer survival. © 2021 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology

Resumen La cirugia minimamente invasiva permite el tratamiento de los tumores de la union esofagogastrica en condiciones de seguridad, reduciendo las complicaciones respiratorias y parietales y mejorando la recuperacion postoperatoria, manteniendo ademas los principios de la cirugia oncologica que permitan obtener unos resultados optimos de efectividad a largo plazo. Para ello, es necesario un volumen de actividad suficiente y avanzar en la curva de aprendizaje de forma tutelada, para poder garantizar una reseccion R0 y una linfadenectomia adecuada. La minima invasion no puede ser un objetivo en si misma. En caso de gastrectomia total, el riesgo de afectacion del margen proximal obliga a verificarlo mediante biopsia intraoperatoria, sin descartar la cirugia abierta de entrada. Por su parte, la esofagectomia minimamente invasiva se ha ido imponiendo progresivamente. Su principal dificultad, la anastomosis intratoracica, puede realizarse mediante una sutura laterolateral mecanica o manualmente asistida por robot, gracias a la vision tridimensional y a la versatilidad del instrumental.

Minimally invasive surgery provides for the treatment of esophagogastric junction tumors under safe conditions, reducing respiratory and abdominal wall complications. Recovery is improved, while maintaining the oncological principles of surgery to obtain an optimal long-term outcome. It is important to have a sufficient volume of activity to progress along the learning curve with close expert supervision in order to guarantee R0 resection and adequate lymphadenectomy. Minimal invasiveness ought not become an objective in itself. Should total gastrectomy be performed, the risk of a positive proximal margin makes intraoperative biopsy compulsory, without ruling out a primary open approach. Meanwhile, minimally invasive esophagectomy has been gaining ground. Its main difficulty, the intrathoracic anastomosis, can be safely carried out either with a mechanical side-to-side suture or a robot-assisted manual suture, thanks to the 3-D vision and versatility of the instruments.

To describe the experience of the robotic approach for achalasia surgery in a tertiary center.Patients with achalasia who underwent robotic surgery between May 2010 and April 2019 were analyzed. The study variables were collected in a prospective database and a descriptive analysis was performed.45 patients (55.6% male) with a mean age of 44 years were included. The main symptom at diagnosis was dysphagia. 19 patients (42.2%) received endoscopic treatment prior to surgery, mostly pneumatic dilation (84.2%). Heller's myotomy associated with Toupet fundoplication was the surgical technique of choice, with a mean operative time of 211minutes. The average stay was 5 days. There were 2 postoperative perforations (4.4%). Perioperative mortality was 0%. The mean follow-up was 64 months. At 3 and 5 years, a significant decrease in the Eckardt score was observed and the manometric study showed a decrease in the lower esophageal sphincter pressure at rest of 58% and 70%, respectively, with persistence of hypomotility of the esophageal body. Pathological gastroesophageal reflux was diagnosed in two patients (5.4%) and 4 (10.8%) presented recurrence of symptoms, requiring endoscopic pneumatic dilations. In 2 cases, the dilations were not effective, so an endoscopic myotomy was considered.In our experience, robotic surgery is a safe and effective procedure for the treatment of achalasia.

Resumen Introduccion La reconstruccion esofagica mediante gastroplastia con anastomosis cervical es una tecnica una mayor dehiscencia anastomotica remarcable.. El objetivo de este estudio es analizar la incidencia de dehiscencia anastomotica en pacientes sometidos a gastroplastia con anastomosis cervical tras acondicionamiento isquemico angiografico del tubo gastrico. Metodos Analisis prospectivo de pacientes que se sometieron a acondicionamiento gastrico 2 semanas antes de la reconstruccion esofagica, desde enero de 2001 hasta enero de 2014. El acondicionamiento se realizo mediante embolizacion angiografica de las arterias gastricas izquierda y derecha, y la arteria esplenica. La variable principal analizada fue la incidencia de dehiscencia anastomotica en pacientes sometidos a gastroplastia con anastomosis cervical. Las variables secundarias analizadas fueron el exito del acondicionamiento, las complicaciones tras este procedimiento y postoperatorias, y la duracion media de la estancia hospitalaria postacondicionamiento. Resultados El acondicionamiento gastrico se indico en 97 pacientes, siendo la neoplasia la etiologia mas frecuente que motivo la reconstruccion esofagica (76%). Se realizaron 96 procedimientos con exito, la embolizacion arterial fue completa en 80 (83%). La morbilidad fue del 13%, sin mortalidad. La morbilidad postoperatoria fue del 45%; las complicaciones mas frecuentes asociadas a la cirugia fueron los respiratorios. Seis (7%) pacientes presentaron fistula cervical y todos tratados de forma conservadora. La mortalidad postoperatoria fue del 7%. Conclusiones En nuestra serie, la incidencia de dehiscencia anastomotica en pacientes sometidos a gastroplastia con anastomosis cervical tras acondicionamiento isquemico angiografico es del 7%. El acondicionamiento isquemico angiografico es un procedimiento con una morbilidad aceptable.

Introduction Oesophageal reconstruction by gastroplasty with cervical anastomosis has a higher incidence of dehiscence. The aim of the study is to analyze the incidence of anastomotic leakage in patients undergoing gastroplasty with cervical anastomosis following angiographic ischemic conditioning of the gastric conduit. Methods Prospective analysis of patients who underwent gastric conditioning two weeks prior to oesophageal reconstruction, from January 2001 to January 2014. The conditioning was performed by angiographic embolization of the left and right gastric artery, and splenic artery. The main variable analyzed was the incidence of anastomotic leakage in patients undergoing gastroplasty with cervical anastomosis. Secondary variables analyzed were the result of the conditioning, complications arising from that procedure and in the postoperative period, and mean length of postconditioning and postoperative hospital stay. Results Gastric conditioning was indicated in 97 patients, with neoplasia being the most frequent etiology motivating the oesophageal reconstruction (76%). 96 procedures were successfully carried out, arterial embolization was complete in 80 (83%). The morbidity rate was 13%, with no mortality. Postoperative morbidity was 45%; the most frequent complications associated with the surgery were respiratory problems. Six (7%) patients experienced cervical fistula, and all received conservative treatment. The rate of postoperative mortality was 7%. Conclusions In our series the incidence of anastomotic leakage in patients undergoing gastroplasty with cervical anastomosis following angiographic ischemic conditioning is 7%. Angiographic ischemic conditioning is a procedure with acceptable morbidity.

Resumen Introduccion El tratamiento del cancer de esofago con pretension curativa requiere un planteamiento multidisciplinar. La terapia neoadyuvante, la radicalidad de la reseccion y la extension de la linfadenectomia pueden incrementar la morbimortalidad postoperatoria. El objetivo de este estudio es analizar los resultados del tratamiento quirurgico del cancer de esofago desde la creacion del Comite de Tumores Esofagogastricos. Metodos Estudio retrospectivo (de enero de 2005 a marzo de 2012) de todos los pacientes con cancer de esofago o de la union esofagogastrica a los que se les realizo una esofagectomia. Se analizaron el tipo de reseccion, las complicaciones postoperatorias, la mortalidad y la supervivencia. Resultados : A 100 pacientes de un total de 392 diagnosticados se les realizo una esofagectomia. En 74 casos se administro tratamiento neoadyuvante. Se realizaron 82 esofagectomias transtoracicas en 2 o 3 campos, 10 esofagectomias transhiatales y 8 coloplastias. En 98 pacientes la reseccion fue R0. Se diagnosticaron 9 dehiscencias anastomoticas intratoracicas y 6 cervicales. La morbilidad global fue del 42% y la mortalidad hospitalaria y a los 90 dias fue del 2%. La mediana de la estancia hospitalaria fue de 16 dias. La supervivencia actuarial al ano es del 82% y a los 5 anos, del 56%. Conclusiones El tratamiento quirurgico con intencion curativa de la neoplasia de esofago solo es posible en una cuarta parte de los pacientes diagnosticados. La elevada morbilidad se debe, sobre todo, a complicaciones toracicas.

Introduction Treatment of oesophageal cancer with curative intent requires a multidisciplinary approach. Neoadjuvant therapy, the radicality of resection and extension of lymphadenectomy have been associated with increased operative morbidity and mortality. The aim of this study was to assess the results of surgical treatment of oesophageal cancer since the presence of an interdisciplinary esophagogastric tumour board. Methods Patients with cancer of the oesophagus and oesophagogastric junction who underwent oesophagectomy between January 2005 and March 2012 were included in this retrospective study. Data concerning type of resection, postoperative complications, mortality and survival were analysed. Results Of the 392 patients with a diagnosis of oesophageal cancer over the study period, 100 underwent oesophagectomy. Seventy-four patients received neoadjuvant treatment. Eighty-two patients underwent transthoracic resection while a transhiatal was used in 10 patients. Colon interposition was required in 8 cases. An R0 resection was achieved in 98 patients. Anastomotic leaks developed in 15 patients, 9 were intrathoracic and 6 were cervical. Postoperative morbidity occurred in 42% of patients, and intra-hospital and 90-day mortality was 2%. Median length of hospital stay was 16 days. The respective actuarial survival at 1 and 5 years were 82% and 56%. Conclusions Surgical treatment with curative intention for oesophageal cancer is only possible in a quarter of patients diagnosed. The high morbidity rate was mainly due to intrathoracic complications.

The aims of present study were to analyze the mortality risk factors in patients who had surgery for acute pancreatitis and to assess the importance of culturing peripancreatic tissue or fluid infection to ascertain the infection status.Surgery was indicated both in patients with infected severe acute pancreatitis and in those with sterile pancreatitis with an unfavorable course. During surgery, cultures were taken of tissues (pancreatic necrosis and peripancreatic fat), intra-abdominal fluid, and bile.Of 107 patients operated on, fluid culture was analyzed in 94 patients, pancreatic necrosis in 61 patients, peripancreatic fat in 39 patients, and bile in 38 patients. Sterile pancreatitis with sterile ascites was found in 17 patients, sterile pancreatitis with infected ascites in 22, and pancreatic tissue infection in 60. Multivariate analysis demonstrated that sterile tissue cultures, age over 65 years, and fewer than 12 days between the beginning of pain and surgery were risk factors for mortality. Sterile pancreatitis with sterile ascites and sterile pancreatitis with infected ascites had similar postoperative mortality (41% and 50%, respectively); the group with pancreatic tissue infection had a lower mortality (20%).Early surgery, advanced age, and sterility of tissue cultures have been demonstrated as mortality factors for acute pancreatitis. Intra-abdominal fluid may be infected in the presence of sterile necrosis.

Treatment of oesophageal cancer with curative intent requires a multidisciplinary approach. Neoadjuvant therapy, the radicality of resection and extension of lymphadenectomy have been associated with increased operative morbidity and mortality. The aim of this study was to assess the results of surgical treatment of oesophageal cancer since the presence of an interdisciplinary esophagogastric tumour board.Patients with cancer of the oesophagus and oesophagogastric junction who underwent oesophagectomy between January 2005 and March 2012 were included in this retrospective study. Data concerning type of resection, postoperative complications, mortality and survival were analysed.Of the 392 patients with a diagnosis of oesophageal cancer over the study period, 100 underwent oesophagectomy. Seventy-four patients received neoadjuvant treatment. Eighty-two patients underwent transthoracic resection while a transhiatal was used in 10 patients. Colon interposition was required in 8 cases. An R0 resection was achieved in 98 patients. Anastomotic leaks developed in 15 patients, 9 were intrathoracic and 6 were cervical. Postoperative morbidity occurred in 42% of patients, and intra-hospital and 90-day mortality was 2%. Median length of hospital stay was 16 days. The respective actuarial survival at 1 and 5 years were 82% and 56%.Surgical treatment with curative intention for oesophageal cancer is only possible in a quarter of patients diagnosed. The high morbidity rate was mainly due to intrathoracic complications.