[Is the palliative treatment of XXXX by retrosternal bypass justified?].

@entity1 @entity5 @entity957 @entity254 @entity189 @entity292 @entity418 @entity420
We report a retrospective study of 52 @entity1 with unresectable @entity189 of the esophagus treated with substernal bypass without resection. There were 49 @entity957 and 3 @entity420 . The site of the @entity5 was the middle third of the esophagus in 32 @entity1 , the upper third in 9, and the lower third in 11. The diagnosis of inextirpability was made preoperatively in 34 @entity1 and at laparotomy in 18. Thoracotomy was never performed. The bypass procedure was ileocolic in 22 cases and gastric in 30 cases. No @entity1 had postoperative chemotherapy or radiation therapy. The operative mortality rate was 9.6 p. 100 (5 cases) and the hospital mortality was 19.2 p. 100 (10 cases). Morbidity was 46 p. 100. Twenty-two cervical @entity292 occurred; 19 closed spontaneously. Eighteen endoscopic dilatations and four reoperations were performed for 22 secondary stenoses of the cervical @entity254 . Median survival rate was 6.2 months. We conclude that substernal bypass is a valuable alternative for palliation of @entity418 but that its indications should be limited.
