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Transhiatal esophagectomy: clinical experience and refinements
M B Orringer1, B Marshall, M D Iannettoni
1Department of Surgery, University of Michigan Medical Center, Ann Arbor 48109, USA.
Annals of Surgery
|September 24, 1999
Summary
Transhiatal esophagectomy (THE) is a safe and effective procedure for esophageal resection, offering better outcomes than transthoracic approaches. Refinements have improved safety and reduced hospital stays.
Area of Science:
- Surgical Oncology
- Gastroenterology
- Thoracic Surgery
Background:
- Transhiatal esophagectomy (THE) use has increased, sparking debate on its safety versus transthoracic resection.
- The authors' extensive THE experience offers valuable data for comparison.
Purpose of the Study:
- To review clinical experience with transhiatal esophagectomy (THE).
- To highlight procedural refinements and their impact on outcomes.
Main Methods:
- Retrospective analysis of a prospectively maintained esophageal resection database.
- Inclusion of follow-up data for patients undergoing THE.
Main Results:
- THE performed in 1085 patients (1976-1998), with 98.6% success rate.
- Hospital mortality was 4%; major complications included anastomotic leak (13%).
- Cancer patient survival matched or exceeded transthoracic esophagectomy; 70% had good/excellent functional results.
Conclusions:
- Transhiatal esophagectomy (THE) is feasible for most patients needing esophageal resection.
- THE demonstrates improved safety and fewer complications compared to traditional transthoracic methods.