Oesophagectomy without thoracotomy: first 250 patients
Gupta, N.M.
European Journal of Surgery 162(6): 455-461
1996
ISSN/ISBN: 1102-4151 PMID: 8817222 Document Number: 467109
Objective: To evaluate morbidity, mortality and cure rate after transhiatal oesophagectomy for carcinoma of the oesophagus. Design: Prospective audit. Setting: University hospital, India. Subjects: From December 1986 to June 1993 a total of 250 consecutive patients underwent one stage transhiatal oesophagectomy with cervical oesophagogastrostomy for carcinoma of the oesophagus. Interventions: Transhiatal oesophagectomy. Main outcome measures: Morbidity and mortality. Results: The mortality was 6% (14/250) and complications included recurrent laryngeal nerve palsy (n = 35, 14%), anastomotic leak (n = 38, 15%), respiratory failure (n = 8, 3%), anastomotic stenosis (n = 44, 18%) and anastomotic recurrence (n = 3, 1%). The actuarial survival at one year was 45% and at five years was 5%. Conclusions: Transhiatal oesophagectomy is safe and well tolerated for the treatment of carcinoma of the oesophagus when done with care. Avoidance of thoracotomy, adequate longitudinal clearance, cervical anastomosis, and a short operating time are its main advantages.