気管食道科の現状と将来の展望 外科の立場から

Abstract

The Japanese Society of Bronchoesophagology was established and developed by Dr. J. Ono and some otorhynolaryngologists. Surgeons studied the technique of Esophagoscopic examination from otorhynolaryngologists untill 1960. A flexible esophagoscope was first applied in an ordinary clinic in 1970, and then esophagoscopy using a flexible endoscope became widely used by gastroenterologists and surgeons. Nowadays, diagnosis and treatment using the flexible endoscope have become remarkably developed. Endoscopic mucosal resection (EMR) for mucosal cancer of the esophagus is a routine procedure at present.General surgeons and otorhynolaryngologists work together in the surgical treatment of pharyngoesophageal cancer. As a reconstructive surgery, free jejunal esophagoplasty is the usual method after pharyngo-laryngo-esophagectomy for Ph cancer. In CeIu cancer, pharyngogastrostomy or pharyngocolostomy through the posterior mediastinum is common. Composite reconstruction using stomach and jejunum is carried out in cases with anastomosis in a high position. Double esophageal and pharyngeal cancer has increased recently. Previously, pharyngolaryngectomy and total esophagectomy were definite operative methods. At present, EMR for esophageal cancer is performed in addition to free jejunal reconstruction, when mucosal cancer is suspected. So “team surgery, ” with surgeons and otorhynolaryngologists co-operating, important for improving the prognosis of pharyngoesophageal cancer.