The Results of En Bloc Esophagectomy Compared with Three-Field and Two-Field Dissection

  • Hiromasa Fujita
  • Teruo Kakegawa
  • Hideaki Yamana
  • Arnulf H. Hölscher
  • Elfriede Bollschweiler
  • J. Rüdiger Siewert


The technique employed for radical esophagectomy performed for a carcinoma in the thoracic esophagus differs geographically in that en bloc esophagectomy is more common at hospitals in Europe and North America [1,2], while three-field dissection is preferred in Japan [3]. The main difference between these two procedures is that cervical and upper mediastinal lymph node dissection is performed in three-field dissection and is not performed in en bloc esophagectomy. In order to evaluate the significance of such dissection, we compared the operative results for en bloc esophagectomy in the Technical University of Munich (TU Munich) with those for two or three-field dissection in Kurume University (Kurume).


Cervical Lymph Node Mediastinal Lymph Node Thoracic Esophagus Resected Lymph Node Mediastinal Lymph Node Dissection 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Skinner DB (1983) En bloc resection for neoplasms of the esophagus and cardia. J Thorac Cardiovasc Surg 85: 59–69PubMedGoogle Scholar
  2. 2.
    Siewert JR, Liebermann-Meffert D, Fekete F, Dittler HJ, Fink U, Lukas P, Ries G (1990) Oesophaguscarcinom. In: Siewert JR, Harder F, Allgower M, Blum AL, Creutzfeldt W, Hollender LF, Peiper HJ (eds) Chirurgische gastroenterologie (in German), vol. 2. Springer, Berlin Heidelberg New York, pp 593–674Google Scholar
  3. 3.
    Isono K, Sato H, Nakayama K (1991) Results of a nationwide study on the three-field lymph node dissection of esophageal cancer. Oncology 48: 411–420PubMedCrossRefGoogle Scholar
  4. 4.
    International Union Against Cancer (1987) The general rules of the TNM system. In: Hermanek P, Sobin LH (eds) TNM classification of malignant tumours, 4th edn. Springer, Berlin Heidelberg New York, pp 5–12Google Scholar
  5. 5.
    Orringer MB (1987) Transthoracic versus transhiatal esophagectomy: What difference does it make? Ann Thorac Surg 44: 116 - 118PubMedCrossRefGoogle Scholar
  6. 6.
    Logan A (1963) The surgical treatment of carcinoma of the esophagus and cardia. J Thorac Cardiovasc Surg 46: 150–161PubMedGoogle Scholar
  7. 7.
    Kinoshita I, Ohashi I, Nakagawa K, Kajitani T, Kaneda K, Tsuya A (1976) Lymph node metastasis in esophageal cancer; with special reference to upper mediastinum and measures for its treatment (in Japanese). Nippon Shyokaki Geka Gakkai Zasshi 9: 424–430CrossRefGoogle Scholar
  8. 8.
    Sannohe Y, Hiratsuka R, Doki K (1981) Lymph node metastasis in cancer of the thoracic esophagus. Am J Surg 141: 216–218PubMedCrossRefGoogle Scholar
  9. 9.
    Sannohe Y (1981) Cervical lymph node metastasis in carcinoma of the esophagus. Nippon Shyokaki Geka Gakkai Zasshi 14: 1016–1022CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Tokyo 1993

Authors and Affiliations

  • Hiromasa Fujita
  • Teruo Kakegawa
  • Hideaki Yamana
    • 1
  • Arnulf H. Hölscher
  • Elfriede Bollschweiler
  • J. Rüdiger Siewert
    • 2
  1. 1.The First Department of SurgeryKurume University School of MedicineKurume, Fukuoka, 830Japan
  2. 2.Department of SurgeryTechnical University of MunichMünchen 80Germany

Personalised recommendations