[Early results of esophageal surgery in carcinoma]

The aim of this study was the evaluation of early results of esophageal resection for cancer including the assessment of pre-operative risk factors and post-operative mortality (risk score developed by Barthels et al. 1998).

One hundred and eighty one patients with esophageal cancer were operated with curative intention between October 1993 and December 2002. In a prospective analysis were reviewed: patient characteristics, characteristics of the esophageal cancer, part and type of esophageal resection, radicality, complications and mortality.

In total, a resection of the tumor could be achieved in 143 cases (79.0%). The overall complication rate was 52.5%, mainly cardio-pulmonary complications (25.9%) were seen. The surgical complications were determined by anastomotic leak (12.6%) and recurrent nerve injury (9.1%). Both types of complications were observed significantly more often after esophageal resection with a cervical anastomosis (p = 0.03 and p < 0.01). The hospital mortality was 8.4%. The 30 days mortality was 4.9%. Using a preoperative risk score retro- and prospectively, our data showed a lower mortality in patients with a low risk profile (2.4% and 2.3%) compared to those with a medium risk profile (7.4% and 6.4%). The only patient with a high risk profile died after resection.

The results of this analysis show that resection of esophageal cancer can be accomplished with acceptable morbidity and mortality. However, it has to be taken into account that the increase of pre-operative factors leads to an increase in post-operative mortality.