Transhiatal versus transthoracic esophagectomy for adenocarcinoma of the distal esophagus and cardia
| Autor: | Romano Delcore, George E. Pierce, Arlo S. Hermreck, James H. Thomas, Steven P. Stark, William R. Jewell, Jon F. Moran, Michael S. Romberg, George Cherian |
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| Rok vydání: | 1996 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Esophageal Neoplasms medicine.medical_treatment Adenocarcinoma Anastomosis Postoperative Complications Stomach Neoplasms Laparotomy medicine Humans Thoracotomy Esophagus Survival rate business.industry Esophageal disease Cardia General Medicine Middle Aged Thorax medicine.disease digestive system diseases Surgery Esophagectomy Survival Rate medicine.anatomical_structure Female business |
| Zdroj: | The American Journal of Surgery. 172:478-482 |
| ISSN: | 0002-9610 |
| Popis: | Background Transhiatal esophagectomy is a popular method of resection because of its reported lower morbidity and mortality and similar survival rates compared to transthoracic esophagectomy. A review of recent experience with these two procedures for resection of distal esophageal and cardia adenocarcinoma is reported. Methods F rem 1988 to 1994, 48 patients with adenocarcinoma of the distal esophagus and gastric cardia were resected with intent to cure, 32 by transhiatal esophagectomy (group I) and 16 by transthoracic esophagectomy (group II). The two groups were comparable in terms of patient demographics, preoperative risk factors, tumor stage, tumor differentiation, and involvement of resection margins (all not significant [NS]). Results There was no significant difference in median intensive care unit stay, median hospital stay, incidence of postoperative anastomotic leak, and stricture. Respiratory complications were higher in group I (41% versus 6%, P = 0.01). Hospital mortality was not significantly different for the two groups (group I 3.1% versus group II 0%, NS). Actuarial 5-year survival rates (Kaplan-Meier) were 12% for group I and 39% for group II (NS). Conclusions These results suggest that when compared with transhiatal esophagectomy, the transthoracic approach is at least as safe, has comparable complication and survival rates, and remains an acceptable procedure for resection of adenocarcinomas of the distal esophagus and gastric cardia. |
| Databáze: | OpenAIRE |
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