الفهرس 
SURGICAL ANATOMY OF THE ESOPHAGUSOnly 14 pages are availabe for public view
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Abstract
Esophageal cancer is the 7th most common malignancy worldwide. However, the incidence shows marked geographical variations.
In the United States, most cases of esophageal carcinoma occur in adults over the age of 50 with male-to-female ratio 3:1, accounting for l% - 2% of all cancer deaths.
Like other malignancies, the etiology of cancer esophagus is still unclear; however, the following predisposing factors may be included: Barrett’s esophagus, achalasia, and esophageal diverticulae and webs.
Dysphagia and weight loss are the commonest presenting symptoms but the patients with esophageal cancer may be presented with epigasteric pain, regurgitation and vomiting .
Cancer esophagus can be diagnosed in addition to the history and clinical examination via barium esophago-gram, esophagoscope, endoscopic ultrasound, CT-chest and other less significant measures.
The treatment of esophageal cancer will depend on selecting the best risk/benefit ratio, modified by the patient’s preferences and available professional expertise. Stage-directed therapy offers a rational approach to attempt cure, prolongation of survival, or palliation.
Patients with early disease (stages 0,1, and IIa) are usually cured with surgery alone. Endoscopic resection or ablation may be curative in stage 0 and I. In advanced esophageal cancer (stages IIb and III), surgery, radiation, and chemotherapy in combination are associated with modest prolongation of survival, but with high morbidity and low cure rates. In patients with metastatic disease (stage IV), surgery usually should be deferred. Radiation and chemotherapy may provide palliation. For most patients with advanced regional cancer or metastatic disease, a variety of endoscopic methods can provide palliation of malignant dysphagia. Patients should be encouraged to enter clinical trials designed to improve the treatment of esophageal cancer .
For benign esophageal tumours like lieomyoma : The mortality rate associated with enucleation is less than 2% and success in relieving the dysphagia is near 100%.
The overall prognosis for patients undergoing surgery for esophageal cancer remain disappointing, with l-and 5-years survival rates of around 50 and 10-20 per cent respectively. These figures are little improved over those reported 30 years ago despite improvements in operative technique and preoperative management survival has not been improved uniformly by neoadjuvant or adjuvant therapy .