[Transhiatal versus transthoracic esophagectomy: experience of the Brazilian National Cancer Institute].
| Autor: | Prisco EL; Seção de Cirurgia Abdomino-Pélvica do Instituto Nacional de Câncer (INCA), Ministério da Saúde do Brasil, Rio de Janeiro., Pinto CE, Barros AV, Reis JM, de Almeida HI, de Mello EL |
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| Jazyk: | portugalština |
| Zdroj: | Revista do Colegio Brasileiro de Cirurgioes [Rev Col Bras Cir] 2010 Jun; Vol. 37 (3), pp. 167-74. |
| DOI: | 10.1590/s0100-69912010000300003 |
| Abstrakt: | Objective: Analyses of morbidity, mortality and overall survival after transhiatal (TH) or transthoracic (TT) esophagectomy. Methods: Retrospective non randomized study of 68 patients with esophagus neoplasia operated in the Brazilian National Cancer Institute between 1997 and 2005. We divided in two groups: Group 1--TH (33 patients); and Group 2--TT (35 patients). Results: The mean age was 40.7 years old (25-74 years old), being 73.5% male. Middle third tumors predominated in Group 2 (48.6% vs. 21.2%, p = 0,02). The mean of dissected lymph nodes was biggest in Group 2 (21.6 vs. 17.8 lymph nodes, p = 0.04), however without difference in number of metastatic lymph nodes (4.1 vs. 3.9 linfonodos, p = 0.85). The mean of operative time was higher in Group 2 (410 vs. 270 minutes, p = 0.001). Also the mean of length of stay was higher in Group 2 (19 vs. 14 days, p = 0.001). The operative morbidity was 50%, without statistical difference between the groups (42.4% vs. 57.1%, p = 0,23). Esophageal leakage occurred in 13.2% of cases, also without statistical difference (9.1% vs. 17.1%, p = 0.23). The mortality was 5.8% (04 patients), without statistical difference (1.4% vs. 4.4%, p = 0,83). Conclusion: In our study, the morbidity and mortality showed no statistical difference in relation to the access performed, although higher operative time and length of stay were observed in TT access. The 3 and 5-years overall survival also were biggest in TT access, probably due to the biggest frequency of patients on initial stages between the submitted to the TT access. |
| Databáze: | MEDLINE |
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