Abstract
In 1920 Kirschner described an operation to bypass oesophageal strictures. In this operation the stomach is brought to the neck by the subcutaneous route and the fundus anastomosed to the proximal end of the divided cervical oesophagus. The distal cervical oesophagus is closed and the intra-abdominal oesophagus is drained into a Roux-en-Y loop of jejunum. This paper reports the performance of this operation on 15 African patients with carcinoma of the oesophagus invading the tracheobronchial tree. There were no operative deaths and all the patients could eat a normal diet after the operation. Ten patients also received radiation therapy to the tumour. The technique of the operation and the late results of treatment are discussed.
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