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[How safe is high intrathoracic esophagogastrostomy?]
A H Hölscher1, W Schröder, E Bollschweiler
1Klinik und Poliklinik für Visceral- und Gefässchirurgie der Universität zu Köln, Cologne. Arnulf.Hoelscher@medizin.uni-koeln.de
Der Chirurg; Zeitschrift Fur Alle Gebiete Der Operativen Medizen
|August 21, 2003
Summary
Transthoracic en bloc esophagectomy with high intrathoracic esophagogastrostomy shows a 5.5% hospital mortality rate. While generally safe, this esophageal surgery demands careful postoperative management to address complications like anastomotic leakage.
Area of Science:
- Oncology
- Thoracic Surgery
- Gastroenterology
Background:
- Esophageal cancer presents significant surgical challenges.
- Transthoracic en bloc esophagectomy is a complex procedure.
- High intrathoracic esophagogastrostomy is a reconstructive technique following esophagectomy.
Purpose of the Study:
- To present the surgical outcomes of transthoracic en bloc esophagectomy.
- To evaluate the safety and efficacy of high intrathoracic esophagogastrostomy.
- To analyze postoperative complications and mortality in esophageal cancer surgery.
Main Methods:
- Retrospective analysis of 109 consecutive patients undergoing transthoracic en bloc esophagectomy.
- Inclusion of patients with adenocarcinoma, squamous cell carcinoma, and other esophageal neoplasms.
- Assessment of preoperative risk, neoadjuvant therapy, lymph node dissection, and postoperative outcomes.
Main Results:
- Hospital mortality was 5.5% (6/109 patients).
- Anastomotic leakage occurred in 8.2% (9/109 patients), with successful management in 6 patients.
- Anastomotic stenosis was infrequent (1.9% of discharged patients).
Conclusions:
- Transthoracic en bloc esophagectomy with high intrathoracic esophagogastrostomy is a viable surgical option for esophageal cancer.
- The procedure demonstrates acceptable safety with diligent postoperative care.
- Management of anastomotic complications is crucial for patient recovery.