Ruolo della broncoscopia nella valutazione preoperatoria del cancro dell’esofago

The aim of this study was to verify the value of bronchoscopy in assessing the resectability of esophageal cancer before surgery. Ninety-five patients with cancer of the esophagus were included in the study. Bronchoscopic findings were grouped to form a personal classification in order to obtain an accurate staging and a correct surgical approach. Particular attention was paid to the evaluation of tracheobronchial motility as an index of the involvement of the respiratory tree. Patients were grouped into three classes. Patients in class I (Absence of bronchoscopic abnormalities) were declared operable and underwent surgery beginning the operation from the laparotomic stage followed by thoracotomy for the resection of the growth and reconstruction of the digestive tract. The exeresis of the tumour was always possible (except for a mass infiltrating the azygos vein) and bronchoscopic diagnosis was confirmed. In 'doubtful' patients (class II) the operation was performed in three stages: thoracotomy, laparotomy and re-thoracotomy. Surgery always confirmed the accuracy of the bronchoscopic assessment. Patients with evidence of tracheobronchial infiltration (class III) were excluded from surgery. The Authors conclude that the routine performance of bronchoscopy provides useful information in order to assess the correct surgical strategy for each patient.